Follow-up del carcinoma orale: Rischio di recidiva, alimentazione, logopedia e fisioterapia = Follow-up in oral cancer: recurrence risk, nutrition, speech therapy and physiotherapy

OBJECTIVES This literature review aims to provide an update for the entire dental team on follow-up in patients affected by oral cancer. In particular are investigated the risk of recurrence and its incidence, nutrition as well as speech therapy and physiotherapy rehabilitation in the patient with oral cancer. MATERIALS AND METHODS We queried the most important bio-medical databases (PubMed, Embase) and Google Scholar in search of articles relevant to the objectives of the article. The full texts of these articles were obtained. The information acquired was further integrated with texts and data already available to the authors. RESULTS Despite the significant improvements in cancer diagnostics and treatment methods, the recurrences onset re-mains one of the main problems in the management of oral cancer. Secondary lesions cause a drastic worsening in prognosis of oncological patients. Recurrences onset depend on various risk factors, which include aspects related to the qualitative and histological features of the tumor, the ability to completely remove the neo-plastic lesion, and the patient’s habits and lifestyle. In order to allow an early diagnosis of recurrence, a strict follow-up of at least 5 years is mandatory. The follow-up program may be customized according to the patient’s risk of recurrence. Due to the anatomical site affected, the treatment of oral cancer has a major negative impact on the patient’s ability to eat adequately. The patient with oral cancer mani-fests xerostomia, mucositis, anatomi-cal-functional alterations of the oral cavity, nausea, vomiting and anorexia, perhaps more than other cancer pa-tients, conditions that contribute to establishing a picture of cachexia, sarcopenia and malnutrition by defect in these subjects. Therefore, the evaluation of the nutritional status and subsequent nutritional therapy should be integral parts of the diagnostic-therapeutic-care pathway of the cancer patient, for the timely prescription of a personalized diet. The physiotherapist and logopedic rehabilitations are recommended for patients who underwent surgical and oncological procedures of the tongue. These interventions are recommended to achieve the correct motor patterns that are necessary to re-establish swallowing and articulatory skills. Through specific exercises, the patient can reach a better quality of life (QOL). CONCLUSIONS In patients affected by oral cancer, a strict follow-up is mandatory in order to identify any recurrences at an early stage, ensuring higher survival and a better quality of life. Considering the anatomical site in-volved by surgery, the evaluation of the nutritional status and the prompt development of a personalized nutritional plan, such as speech therapy and physiotherapy rehabilitation, should be integral parts of the therapeutic-care in patients with oral cancer. CLINICAL SIGNIFICANCE Oral cancer is a pathology which must be known and recognized by the entire dental team, in order to be able to establish a correct follow-up protocol and offer patients adequate information about nutrition, speech therapy and physiotherapy rehabilitation.