Long term functional survivorship in oral cavity cancer: Quality of life (QOL) outcomes by return to work (RTW) status.

6107 Background: Long-term survivors of oral cavity cancer (OCC) often experience persistent physical, functional, and psychosocial impairments despite disease control. Return to work (RTW) reflects real-world functional recovery and social reintegration. We evaluated whether health-related quality of life (QOL) differs between OCC survivors who returned to work and those who did not. Methods: This prospective cohort study included OCC survivors ≤65 years who underwent definitive surgery between 2016 and 2023 and were disease-free for ≥2 years. Health-related QOL was assessed using EORTC QLQ-C30, EORTC QLQ-HN43, and UW-QOL questionnaires. QOL domains were compared between survivors who returned to work and those who did not. Results: Three hundred OCC survivors were evaluated at a median of 28.5 months after treatment. Survivors who returned to work demonstrated significantly higher global health status and superior physical, role, emotional, cognitive, and social functioning on EORTC QLQ-C30 compared with non-working survivors (all p<0.0001). Non-working survivors had substantially greater head-and-neck–specific symptom burden on EORTC QLQ-HN43, including swallowing difficulty, speech problems, shoulder dysfunction, pain, dry mouth, body-image disturbance, social eating limitations, and fear of progression (all p<0.0001). UW-QOL confirmed significantly worse pain, activity, recreation, swallowing, chewing, speech, shoulder function, mood, anxiety, and overall health-related QOL in survivors who did not return to work (all p<0.0001). Conclusions: Return to work is strongly associated with superior multidimensional quality of life in oral cavity cancer survivors. Survivors who do not resume work experience profound physical, functional, and psychosocial impairment, highlighting the need for rehabilitation-centered survivorship care to restore meaningful functional recovery beyond oncologic cure. Quality of life scores for European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 43 (EORTC QLQ HN 43). EORTC QLQ HN 43 Total patients (Overall population ) Returned to work at the time of survey (Mean + SD) Did not return to work at the time of survey (Mean + SD) P Value Pain in the mouth 34.2 + 15.8 10.3+ 13.2 33.2 + 13.5 p<0.0001 Swallowing issue 10.8 + 12.5 7.8 + 8.7 25.5 + 16.9 p<0.0001 Problems with teeth 17.8 + 19.2 14.1 + 17.2 35.7 + 18.6 p<0.0001 Dry mouth and sticky saliva 23.4 + 21.9 19.5 + 19.1 42.8 + 24.3 p<0.0001 Problems with senses 18.1 + 18.9 14.2 + 16.6 36.9 + 18.0 p<0.0001 Speech issues 15.9 + 18.8 11.6 + 15.4 44.9 + 17.2 p<0.0001 Body image issues 18.0 + 19.7 12.5 + 15.2 41.3 + 20.1 p<0.0001 Social eating issues 17.0 + 19.9 12.0 + 15.7 47.1 + 22.5 p<0.0001 Sexuality problem 18.1 + 22.7 12.2 + 17.6 46.4 + 18.3 p<0.0001 Problems with shoulder 18.6 + 22.0 12.9 + 17.9 46.4 + 18.3 p<0.0001 Skin Problems 13.5 + 18.5 9.0 + 14.7 35.7 + 19.4 p<0.0001