Effect of comorbidity on post‐treatment quality of life scores in patients with head and neck squamous cell carcinoma

Gourin, Christine G.; Boyce, Brian; Vaught, Creighton; Burkhead, Lori M.; Podolsky, Robert H.

doi:10.1002/lary.20199

Cited by 26 publications

(12 citation statements)

References 15 publications

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“…Furthermore, Gourin et al . [18] concluded that co-morbidity alone did not appear to affect 1-year post-treatment head and neck disease-specific QOL indices in their study and Ronis et al . [19] also reported that head and neck disease-specific domains were less affected by co-morbid illness.…”

Section: Discussionmentioning

confidence: 83%

Two-year quality of life after free flap reconstruction in tumor-site discrepancy among Taiwanese with moderately advanced oral squamous cell carcinoma

et al. 2012

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BackgroundThis study describes 2-year impact on quality of life (QOL) in relation to the anatomical discrepancy among T4a oral cancer patients after free flap reconstruction in Taiwan.MethodsThirty-two patients who underwent tumor ablation with simultaneous microvascular free flap transfer at 2-year follow-up were recruited. They were divided into six subgroups, according to the resected area, consisting of: (1) buccal/retromolar trigone; (2) cheek; (3) commissure; (4) lip; (5) mandible; and (6) tongue. Functional disturbances and daily activity were analyzed using the Version-1 UW QOL Questionnaire with one more specific category: ‘Drooling’. Kruskal-Wallis rank sums analysis was used to test differences in average QOL scores between these subgroups. Post-hoc analysis was applied to assess influence of dominant categories between subgroups.ResultsThe category ‘Pain’ revealed the highest average score and reached significant statistical difference (P = 0.019) among all the categories, however, the category ‘Employment’ averaged the lowest score. Regarding ‘Pain’, there existed a statistical significance (P = 0.0032) between the commissure- and cheek-involved groups, which described the former showed poorer pain quality of life.ConclusionsThe commissure-involved group had the lowest average score, which might imply the worst QOL in our study, especially for the categories ‘Pain’ and ‘Drooling’. This present study of T4a patients was the first carried out in Taiwan implementing the QOL questionnaire, and its results may serve for future reference.

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Section: Discussionmentioning

confidence: 83%

Two-year quality of life after free flap reconstruction in tumor-site discrepancy among Taiwanese with moderately advanced oral squamous cell carcinoma

et al. 2012

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“…18 This is particularly important as QOL measurements are closely linked to patients' emotional status: in one study lower T and N stage were actually associated with poorer QOL as assessed by questionnaire. 19 It therefore follows that patients' perceptions of their illness may affect QOL as much as or even more than the physiological and anatomical extent of their disease.…”

Section: Discussionmentioning

confidence: 99%

Quality of life after treatment of laryngeal carcinoma: a single centre cross-sectional study

Williamson

Ingrams

Jones

2011

annals

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The mainstays of treatment for head and neck cancers include surgery, chemotherapy and radiotherapy given alone or in combination. However, the side effects of these treatments are multifactorial in nature, causing substantial physical as well as psychosocial morbidity.1,2 Their location inherently affects life's basic and vital functions including breathing, feeding and oral communication. Furthermore, altered appearance, difficulty in swallowing and pain as a result of treatment can cause problems with social function and have a further effect on a patient's quality of life (QOL). 3A number of studies have revealed QOL is affected by T and N stage, 4,5 time after treatment and treatment modality. [5][6][7] Investigation into the effect of these factors on specific aspects of QOL such as saliva production and swallowing has yielded varying conclusions. 7-10The aim of this study was to identify whether factors including patient age, treatment modality, tumour stage and nodal status significantly affect quality of life in patients treated for laryngeal cancer. It was hypothesised that patients with advanced T stage and nodal disease would experience poorer QOL. Furthermore, patients undergoing surgical treatment with or without chemoradiotherapy would experience poorer QOL than those undergoing primary radiotherapy.We aimed to identify those aspects of QOL that are significantly affected in order to counsel patients regarding the significant risks and benefits of treatment with uncertain curative outcomes. Furthermore, we aimed to identify patients at risk of significant side effects before treatment in order to effectively prepare them for their treatment experience and focus support from health professionals on the appropriate patients. MethodsThe University of Washington Quality of Life (UW-QOL) questionnaire is a validated tool for determining QOL outcomes in patients treated for head and neck cancer.9,11,12 We used version 3 of the questionnaire (the most current at the time), which consists of ten domain specific questions that ask patients regarding their experiences of pain, appearance, activity level, recreation, swallowing, chewing, speech, shoulder function, taste and saliva production in the last seven days, compared to the month before they de- . We aimed to identify which aspects of QOL and which patients are most affected by the various treatment options. METHODS The University of Washington Quality of Life (UW-QOL) questionnaire was administered to all patients with laryngeal cancer treated at a single institution over a seven-year period (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010). RESULTS In total, 41 patients responded. All had been treated for squamous cell carcinoma of the larynx. Questionnaires were completed at a median of 18.5 months after treatment. The overall quality of life was 81.1/100 as assessed by the UW-QOL scale, with only 4.9% reporting 'poor' or worse QOL. Neither patient age nor time after treatment significantly affected any aspect of QOL. Patients undergoing primary r...

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“…Comorbid conditions (specifically those associated with psychological well‐being) can easily be considered risk factors for worsened sleep 32. The association between increased mortality and comorbidity in head and neck cancer has been proven, although data establishing the relationship between increased comorbidity and poor quality of life has been conflicting 33, 34. The presence of significant comorbidities among head and neck cancer patients, and their significant impact on symptoms including sleep quality, suggest the need to consider a multidisciplinary approach to patients ensuring that all aspects of care are addressed, rather than focusing attention solely on extirpation of their neoplasm.…”

Section: Discussionmentioning

confidence: 99%

Predictors of poor sleep quality among head and neck cancer patients

et al. 2010

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Objectives/Hypothesis The objective of this study was to determine the predictors of sleep quality among head and neck cancer patients 1 year after diagnosis. Study Design This was a prospective, multisite cohort study of head and neck cancer patients (N = 457). Methods Patients were surveyed at baseline and 1 year after diagnosis. Chart audits were also conducted. The dependent variable was a self-assessed sleep score 1 year after diagnosis. The independent variables were a 1 year pain score, xerostomia, treatment received (radiation, chemotherapy, and/or surgery), presence of a feeding tube and/or tracheotomy, tumor site and stage, comorbidities, depression, smoking, problem drinking, age, and sex. Results Both baseline (67.1) and 1-year post-diagnosis (69.3) sleep scores were slightly lower than population means (72). Multivariate analyses showed that pain, xerostomia, depression, presence of a tracheotomy tube, comorbidities, and younger age were statistically significant predictors of poor sleep 1 year after diagnosis of head and neck cancer (P < .05). Smoking, problem drinking, and female sex were marginally significant (P < .09). Type of treatment (surgery, radiation and/or chemotherapy), primary tumor site, and cancer stage were not significantly associated with 1-year sleep scores. Conclusions Many factors adversely affecting sleep in head and neck cancer patients are potentially modifiable and appear to contribute to decreased quality of life. Strategies to reduce pain, xerostomia, depression, smoking, and problem drinking may be warranted, not only for their own inherent value, but also for improvement of sleep and the enhancement of quality of life.

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Effect of comorbidity on post‐treatment quality of life scores in patients with head and neck squamous cell carcinoma

Cited by 26 publications

References 15 publications

Two-year quality of life after free flap reconstruction in tumor-site discrepancy among Taiwanese with moderately advanced oral squamous cell carcinoma

Two-year quality of life after free flap reconstruction in tumor-site discrepancy among Taiwanese with moderately advanced oral squamous cell carcinoma

Quality of life after treatment of laryngeal carcinoma: a single centre cross-sectional study

Predictors of poor sleep quality among head and neck cancer patients

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