Perioperative symptom burden as an independent predictor of long-term functional and survival outcomes in oral squamous cell carcinoma patients undergoing free flap reconstruction: a retrospective cohort study.

All patients underwent primary tumor resection followed by immediate microvascular free flap reconstruction.

Based on the median core severity score on postoperative day 3 (POD 3) of 5.79, patients were stratified into low symptom burden (n=178) and high symptom burden (n=177) groups.

Multivariate analysis identified the area under the curve (AUC) of the perioperative MDASI severity trajectory as an independent predictor for 12-month Speech Handicap Index (B=2.83, 95% CI 1.52-4.14, P=0.001) and UW-QOL scores (B=-3.82, 95% CI -5.14 to -2.50, P=0.001).