Purpose: There is an increasing number of survivors from oropharyngeal cancer who are younger and still of working age, and are faced with the prospect of returning to work (RTW) after treatment. The aim of this study was to investigate the number of patients who RTW after trans-oral robotic surgery (TORS) and to explore their experience of working after treatment, their mental health and overall quality of life (QOL).
Method: A cross-sectional, multi-centre, study undertaken using the TORS database at the Peter MacCallum Cancer Centre (PMCC) and Epworth Healthcare, Melbourne, Australia. Eligible patients were between the age of 18-65 years and were employed at or within the 3 months before diagnosis, and had completed curative treatment with TORS for primary oropharyngeal squamous cell carcinoma (SCC). Participants completed a study specific questionnaire to assess their employment status and return to work, as well as other validated questionnaires including the EORTC QLQ-C30, QLQH&N45 and the HADS.
Results: 46 patients, mean age 55 years (range 39-65 years, 85% men) were included in this preliminary analysis. Majority of patients had tonsillar (52.1%) or base of tongue (32.6%) cancer. Patients were staged using AJCC 8th edition, most were p16 positive. The mean RTW time was 14 weeks after finishing treatment (defined as: date of surgery; or end of chemo/radiotherapy if receiving adjuvant therapy). Patients who had surgery alone returned to work quicker than patient receiving surgery + adjuvant chemo/radiotherapy. Patients also reported overall good QOL and mental health outcomes after TORS; fatigue and pain were the main barriers to RTW.
Conclusion: To our knowledge this is the first study of its kind on patients receiving primary TORS for their oropharyngeal SCC and our results suggest quicker rehabilitation back to work than patients having chemo/radiotherapy as their primary treatment modality from the literature.