Abstract: PURPOSE: To investigate the perioperative symptom clusters and quality of life status in patients with oral and maxillofacial neoplasms undergoing flap transplantation, and to analyze their correlation. METHODS: A convenience sample of 211 patients with oral and maxillofacial neoplasms undergoing flap transplantation who attended Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from December 2022 to December 2023 were longitudinally surveyed. M.D.Anderson Symptom Inventory-Head & Neck and University of Washington Quality of Life Questionnaire (fourth edition) were used, the patients were investigated longitudinally before, 7 days and 1 month after flap transplantation. SPSS 26.0 software package was used for data analysis. RESULTS: Five symptom clusters were derived from patients with oral and maxillofacial neoplasms undergoing flap transplants at 3 time points during perioperative period. The neurological symptom cluster was extracted before and 1 month after surgery, the gastrointestinal symptom cluster was extracted only 7 days after surgery, and the symptom cluster of dysphagia-dysphonia, disease-specific symptom cluster and fatigue-sleep-mood symptom cluster were extracted persisted throughout the perioperative period. The difference of total quality of life scores at the three time points during the perioperative period was statistically significant(P<0.001). The perioperative severity scores of the five symptom clusters were negatively correlated with their total quality of life scores and socio-emotional domain scores(P<0.05). Before surgery, the dysphagia-dysphonia symptom cluster and the fatigue-sleep-mood symptom cluster had significant effect on patients' quality of life(R²=0.613, P<0.05). Seven days after surgery, the dysphagia-dysphonia symptom cluster,the disease-specific symptom cluster and the fatigue-sleep-mood symptom cluster had significant effect on patients' quality of life(R²=0.614, P<0.05). One month postoperatively, the dysphagia-dysphonia symptom cluster, the neurological symptom cluster and the fatigue-sleep-mood symptom cluster had significant effect on patients' quality of life (R²=0.577, P<0.05). CONCLUSIONS: Patients with oral and maxillofacial neoplasms undergoing flap transplantation had multiple stable symptom clusters perioperatively, the more severe the symptom clusters, the worse the patient's quality of life. Effective interventions for the symptom clusters can reduce the severity of the symptom clusters and improve the patient's quality of life.

Key words: Oral and maxillofacial neoplasms, Symptom cluster, Quality of life, Correlation study