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Background: To prescribe early trismus therapy, prognostic factors influencing the restricted mouth opening should be identified first. Our aim is to present an overview of these factors in patients with head and neck cancer. Methods: PubMed, Cochrane, EMBASE, and CINAHL were searched using terms related to head and neck cancer and mouth opening. Risk of bias was assessed using the "Quality in Prognosis Studies" tool. A best evidence synthesis was performed. Results: Of the identified 1418 studies, 53 were included. Three studies contained a prognostic multivariate model for a restricted mouth opening. Conclusions: Patients with head and neck cancer will most likely develop a restricted mouth opening when they have a large tumor near the masticatory muscles that requires extensive cancer treatment. A restricted mouth opening most likely occurs within 6 months after cancer treatment. Further research is necessary on factors related to healing tendency or pain intensity. [ABSTRACT FROM AUTHOR]

Objective: In line with screening guidelines, cancer survivors were consecutively screened on depressive symptoms (as part of standard care), with those reporting elevated levels of symptoms offered psychological care as part of a trial. Because of the low uptake, no conclusions could be drawn about the interventions' efficacy. Given the trial set-up (following screening guidelines and strict methodological quality criteria), we believe that this observational study reporting the flow of participation, reasons for and characteristics associated with nonparticipation, adds to the debate about the feasibility and efficiency of screening guidelines.Methods: Two thousand six hundred eight medium- to long-term cancer survivors were consecutively screened on depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Those with moderate depressive symptoms (PHQ-9 ≥ 10) were contacted and informed about the trial. Patient flow and reasons for nonparticipation were carefully monitored.Results: One thousand thirty seven survivors (74.3%) returned the questionnaire, with 147 (7.6%) reporting moderate depressive symptoms. Of this group, 49 survivors (33.3%) were ineligible, including 26 survivors (17.7%) already receiving treatment and another 44 survivors (30.0%) reporting no need for treatment. Only 25 survivors (1.0%) participated in the trial.Conclusion: Of the approached survivors for screening, only 1% was eligible and interested in receiving psychological care as part of our trial. Four reasons for nonparticipation were: nonresponse to screening, low levels of depressive symptoms, no need, or already receiving care. Our findings question whether to spend the limited resources in psycho-oncological care on following screening guidelines and the efficiency of using consecutive screening for trial recruitment in cancer survivors. [ABSTRACT FROM AUTHOR]

Background Effects of exercise therapy for trismus secondary to head and neck cancer have not been reviewed systematically since 2004. Methods Four databases were searched. The quality of observational studies and randomized controlled trials was assessed. Results Two hundred eleven articles were found, 20 studies were included. A large variation in research methodology, stretching techniques, duration of stretch, and repetition of exercises was found. The overall quality was moderate. Five of the 8 preventive studies found that exercises during (chemo)radiotherapy could not prevent a reduction in mouth opening. In 4 therapeutic case studies, mouth opening increased between 17 and 24 mm. In 8 other therapeutic studies, mouth opening increased between −1.9 and 13.6 mm. No exercise therapy was clearly superior to the others. Conclusion Changes in mouth opening ranged considerably and no stretching technique was superior to others regarding either prevention or treatment of trismus. Clinical guidelines cannot be given based on this systematic review. © 2016 Wiley Periodicals, Inc. Head Neck 39: 160-169, 2017 [ABSTRACT FROM AUTHOR]

Information on epidemiology is essential to evaluate care for the growing group of oral cancer patients. We investigated trends in incidence, mortality and relative survival rates for oral cavity cancer (OCC) and its subsites in the Netherlands from 1991 to 2010, and relate these to changes in stage and treatment. Patient (age, sex), tumour (subsite, stage) and treatment characteristics of patients diagnosed with OCC (ICD-O-3: C02-C06) in 1991-2010 were extracted from the Netherlands Cancer Registry. Incidence, mortality and 5-year relative survival rates over time are presented, as well as trends in type of treatment. The incidence of OCC increased with +1.2% (95%CI: +0.9%;+1.6%) per year: more strongly in women, stage I and IV disease, and in cancers of the tongue and gum. The mortality rate slightly rose (+0.8%, 95%CI: +0.3%;+1.3% per year), but differed by subsite. The 5-year relative survival improved from 57% in 1991-1995 to 62% in 2006-2010. The 5-year relative survival was better for women compared with men (64% and 55%, respectively), decreased with increasing stage, was the best for tongue cancer (63%) and the worst for cancer of the gum (56%) and floor of mouth cancer (55%). The relative excess risk of dying was higher for non-surgery-based treatments. Surgery was the main treatment option and the proportion of 'surgery only' rose in stage I and III disease. The incidence and, to a lesser extent, mortality of OCC are increasing and therefore, even with slightly improving survival rates, OCC is an increasingly important health problem. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background The purpose of this study was to validate bioelectrical impedance analysis (BIA) using the Geneva equation for fat-free mass (FFM) in patients with head and neck cancer. Methods In 24 patients with head and neck cancer, agreement between BIA (FFMBIA) and dual energy x-ray absorptiometry (FFMDXA) 1 week before (T0), 1 month (T1), and 4 months (T2) after cancer treatment was analyzed. Results FFMBIA did not differ from FFMDXA (mean difference 0.71 ± 1.9, 0.30 ± 1.9, and 0.02 ± 2.1 kg) at any time point. Only at T0, mean FFM correlated to the difference between FFMDXA and FFMBIA ( r = 0.48; p = .017). Limits of agreement were 3.8, 3.7, and 4.1 kg, respectively. Concordance Correlation Coefficients were 0.98 at all time points. Conclusion BIA may be used to assess FFM with reasonable validity based on mean-level comparisons, but differences between BIA and DXA may vary by about 4 kg in an individual patient. These results require confirmation in a larger sample of patients with head and neck cancer. © 2013 Wiley Periodicals, Inc. Head Neck 36: 585-591, 2014 [ABSTRACT FROM AUTHOR]

Background. The purpose of this prospective study was to assess the quality of life (QOL) and oral functioning of patients with oral cancer up to 5 years after prosthodontic rehabilitation with mandibular implant-retained overdentures. Methods. Fifty patients who had received implants during ablative surgery were evaluated by standardized questionnaires before and after oncological and prosthetic treatment. Results. In 20 of 24 surviving patients, the dentures were functional after 5 years. In these survivors, oral function remained unchanged during this period. In the 6 patients with concurrent comorbidity, global health and QOL had deteriorated,while in the patients without comorbidity, global health and QOL were very high. Five-year survivors had a higher global health and better oral functioning at the 1-year evaluation than nonsurvivors. Conclusion. Oral function and denture satisfaction were high and did not change over time for survivors. Deterioration in overall global health and QOL was associated with concurrent comorbidity. [ABSTRACT FROM AUTHOR]