India faces one of the world’s highest burdens of oral squamous cell carcinoma (OSCC), predominantly due to the widespread use of smokeless tobacco. While oncological outcomes have improved, many survivors are left with profound speech, swallowing, and masticatory dysfunctions that drastically impair their quality of life. These issues often go under-recognized in clinical practice, despite their impact on psychological well-being, social reintegration, and nutritional status.
Our study sought to fill this gap by longitudinally assessing functional impairments using a validated tool — the EORTC QLQ-H&N43 — and correlating outcomes with tumor site, treatment modality, and reconstructive surgical procedures. We aimed not only to quantify the deficits but also to identify high-risk subgroups who could benefit from targeted rehabilitation or even pre-treatment interventions ("prehabilitation"). By identifying factors associated with worse outcomes — such as tongue and floor-of-mouth tumors, advanced-stage disease, free flap reconstruction, and multimodal therapy — we provide a roadmap for personalizing care beyond the tumor itself.
In a country where patients often present in advanced stages and resources are limited, such insights are critical to integrating functional survivorship into routine oncology.