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RESEARCH PRODUCT

FLiGS Score: A New Method of Outcome Assessment for Lip Carcinoma–Treated Patients

subject

description

Lip cancer represents 25% of all oral cavity carcinomas; it peaks in the sixth and seventh decades, with males predominating by 3 to 1. The lower lip is approximately 12 times more likely to be affected, owing to its greater exposure to the sunlight. Surgical oncologic and reconstructive treatment of lip cancer has advanced dramatically, but lip distortion or loss resulting from neoplasms or from their surgical treatment has considerable functional and cosmetic effects with resultant nutritional, physical, and psychological detriments.1–8 Traditional indicators, such as survival rate and disease-free interval, are no longer adequate for answering questions on outcome not considering the physical and functional sequelae of treatment.9 Questionnaires with a precise number of graded questions are the most practical form of assessment and include a structured approach to capture patient-perceived common problems after treatment and to rank their intensity, providing clinicians with an appropriate outcome evaluation.10–13 Numerous tools to assess posttreatment functional outcomes have been developed and tested, but no gold standard exists to evaluate the specific issues of lip cancer–treated patients. During the last 10 years, we have adopted the FIGS (Functional Intraoral Glasgow Scale) score (Table ​(Table1)1) to assess outcome of patients with oral cancer and reconstructive technique results.14–16 The FIGS score is a simple 5-point scale questionnaire designed to determine the ability of oral cancer patients to speak, chew, and swallow before and after surgery. We found this tool more effective than others due to its simplicity, its clinical relevance, and its objectivity for functional results. Table 1. FIGS Score However, the FIGS score lacks accuracy for lip localization not taking into account the specific problems related to lip cancer as: - The presence of drooling, index of poor oral competence. - The aesthetic impact of the tumor and its surgical treatment. Adding the analysis of these 2 specific parameters to those assessed by FIGS, we aim to develop a new method of outcome assessment in patients who had surgical ablation of lip carcinoma with or without reconstruction: the FLiGS (Functional Lip Glasgow Scale) score (Table ​(Table22). Table 2. FLiGS Score