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

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 Copyright © 2015 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercialNoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. DOI:10.1097/GOX.0000000000000306 Background: Lip cancer and its treatment have considerable functional and cosmetic effects with resultant nutritional and physical detriments. As we continue to investigate new treatment regimens, we are simultaneously required to assess postoperative outcomes to design interventions that lessen the adverse impact of this disease process. We wish to introduce Functional Lip Glasgow Scale (FLiGS) score as a new method of outcome assessment to measure the effect of lip cancer and its treatment on patients’ daily functioning. Methods: Fifty patients affected by lip squamous cell carcinoma were recruited between 2009 and 2013. Patients were asked to fill the FLiGS questionnaire before surgery, 1 month, 6 months, and 1 year after surgery. The subscores were used to calculate a total FLiGS score of global oral disability. Statistical analysis was performed to test validity and reliability. Results: FLiGS scores improved significantly from preoperative to 12 months postoperative values (P = 0.000). Statistical evidence of validity was provided through rs (Spearman correlation coefficient) that resulted >0.30 for all surveys and for which P < 0.001. FLiGS score reliability was shown through examination of internal consistency and test-retest reliability. Conclusions: FLiGS score is a simple way of assessing functional impairment related to lip cancer before and after surgery; it is sensitive, valid, reliable, and clinically relevant: it provides useful information to orient the physician in the postoperative management and in the rehabilitation program. (Plast Reconstr Surg Glob Open 2015;3:e345; doi:10.1097/GOX.0000000000000306; Published online 30 March 2015.) FLiGS Score: A New Method of Outcome Assessment for Lip Carcinoma–Treated Patients