Performance status scale for head and neck scores for oral cancer survivors: predictors and factors for improving quality of life

Takahide Kondo, Akinari Sugauchi, Yusuke Yabuno, Hironobu Kobashi, Katsuhiko Amano, Tomonao Aikawa, Mikihiko Kogo, Masaya Okura

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Objectives: This study aimed to determine the factors associated with long-term quality of life of oral cancer survivors. Materials and methods: A total of 508 survivors were assessed using the performance status scale for head and neck (PSS-HN), which comprises Eating in Public (E-Public), Normalcy of Diet (N-Diet), and Understandability of Speech (U-Speech). Stepwise multiple linear regression analysis was performed. Results: The median time between the end of treatment and participating in the survey was 38 months (range, 6–250). Overall, 57–60% of survivors achieved full performance (100 score) of each PSS-HN score, whereas 15% had moderate or severe impairment (≤ 50 score) in E-Public and N-Diet, and 4% had impairment in U-Speech. These three scores deteriorated with increasing T-stage. Age, soft tissue reconstruction, trismus, and missing occlusal contacts on the contralateral side were significantly associated with E-Public and N-Diet. Neck dissection, hard tissue reconstruction, and missing occlusal contacts bilaterally were associated with U-Speech score. Conclusion: Older age, T4 tumor, and soft tissue reconstruction were predictors of low E-Public and N-Diet performance scores. Increasing mouth opening and maintaining optimal occlusal contacts on the contralateral side may be effective ways to improve N-Diet and E-Public performance. Maintaining optimal occlusal contacts bilaterally may be effective for improving speech performance. Clinical relevance: Oral health care to increase optimal occlusal contacts and rehabilitation of trismus may be promising factors to improve the functional performance of oral cancer survivors.

Original languageEnglish
Pages (from-to)1575-1582
Number of pages8
JournalClinical Oral Investigations
Issue number4
Publication statusPublished - Apr 10 2019
Externally publishedYes


  • Head and neck cancer
  • Mouth opening
  • Multiple linear regression analysis
  • Oral cancer
  • Performance status
  • Quality of life

ASJC Scopus subject areas

  • Dentistry(all)


Dive into the research topics of 'Performance status scale for head and neck scores for oral cancer survivors: predictors and factors for improving quality of life'. Together they form a unique fingerprint.

Cite this