Health-related quality of life and overall survival: a prospective study in patients with head and neck cancer treated with radiotherapy

Nieuwenhuizen, Annette J. van; Buffart, Laurien M.; Langendijk, Johannes A.; Vergeer, Marije R.; Voortman, Jens; Leemans, C. René; Leeuw, Irma M. Verdonck‐de

doi:10.1007/s11136-020-02716-x

Cited by 17 publications

(13 citation statements)

References 47 publications

(65 reference statements)

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“…Shortened operation time improves postoperative recovery and reduces further morbidity. Rehabilitation and reintegration into daily life are key as HRQOL is associated with overall survival in patients with HNC [ 23 , 24 ]. A higher HRQOL not only at diagnosis, but also post-treatment has been shown to result in improved survival rates [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Rehabilitation and reintegration into daily life are key as HRQOL is associated with overall survival in patients with HNC [ 23 , 24 ]. A higher HRQOL not only at diagnosis, but also post-treatment has been shown to result in improved survival rates [ 23 ]. Therefore, the choice of reconstructive method and the postoperative treatment may well be associated with oncological outcome.…”

Section: Discussionmentioning

confidence: 99%

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Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery

et al. 2021

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Background: The pedicled pectoralis major muscle flap (PMMF) is a well established flap for fistula prophylaxis after salvage laryngectomy. To reduce donor site morbidity, we established a modified muscle-sparing harvesting technique. We herein investigate postoperative shoulder function and health-related quality of life (HRQOL). Methods: A chart review of patients receiving the modified muscle-sparing pectoralis major muscle flap between 2013–2020 was performed. Nineteen patients (male = 18, female = 1) were potentially eligible and six male patients were ultimately enrolled. Postoperative shoulder function was assessed on both sides (flap side versus non-flap side) using the Constant Murley Score and the Bak criteria. Health-related quality of life was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire in cancer patients (EORTC QLQ-C30) and head and neck cancer patients (EORTC H&N35). Results: No Constant Murley Score subscale was statistically significant (p ≥ 0.180). Bak criteria was overall rated “Good“. Solely upper extremity adduction force was significantly altered on the flap side (p = 0.039). Median EORTC QLQ-C30 score was 82.2 (IQR 11.1) on the functional scale and 10.3 (IQR 2.6) on the symptomatic scale. Median quality of life score was 75.0 (IQR 33.3) and median EORTC QLQ-H&N35 was 20.6 (IQR 9.8). Conclusions: Postoperative shoulder function after modified muscle-sparing pectoralis major muscle flap surgery is comparable to function of the healthy side with a significant deficiency in adduction force not compromising daily life in this small study cohort.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery

et al. 2021

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“…Though prospective data are lacking, recent retrospective studies have reported beneficial effects of EBRT on selected patients (20)(21)(22). Based on these results, EBRT after final incomplete resections of IR-DTC may offer locoregional control (LRC) and probably overall survival (OS), although radiation related morbidity after extensive repeated surgery will probably influence the quality of life (23). The aim of this study was to evaluate LRC and overall survival (OS) after postoperative EBRT for both microscopic and macroscopic non-radically resected locally advanced IR-DTC, and to assess potential side effects.…”

Section: Introductionmentioning

confidence: 99%

“…Though prospective data are lacking, recent retrospective studies have reported beneficial effects of EBRT on selected patients ( 20 , 21 , 22 ). Based on these results, EBRT after final incomplete resections of IR-DTC may offer locoregional control (LRC) and probably overall survival (OS), although radiation-related morbidity after extensive repeated surgery will probably influence the quality of life ( 23 ).…”

Section: Introductionmentioning

confidence: 99%

Postoperative external beam radiotherapy for locoregional control in iodine refractory differentiated thyroid cancer

Groen

Dijk

Sluiter

et al. 2022

European Thyroid Journal

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Background: The role of postoperative external beam radiotherapy (EBRT) in patients with residual iodine refractory differentiated thyroid cancer (IR-DTC) is still inconclusive. The aim of this retrospective study was to evaluate locoregional control (LRC) and overall survival (OS), and potential side effects after postoperative EBRT for both microscopic and macroscopic non-radically resected locally advanced IR-DTC. Methods: Between 1990 and 2016, 49 patients with locally advanced IR-DTC received EBRT for microscopic (R1; n=28) or macroscopic (R2; n=21) locoregional residual disease. For more insight into the added effect of EBRT we performed an intra-patient sub-analysis in 32 patients who had undergone more than one surgical intervention, comparing LRC after primary, curative-intended surgery with LRC after repeated surgery plus EBRT. To estimate LRC and OS we used Kaplan Meier curves. From 2007 onwards, we prospectively recorded toxicity data in our head and neck cancer database (n=10). Results: LRC rates five years after EBRT were higher for R1 (84.3%) than for R2 (44.9%) residual disease (p=0.016). The five-year OS rate after EBRT was 72.1% for R1 and 33.1% for R2 disease (p=0.003). In the intra-patient analysis (n=32) LRC rates were 6.3% five years after only initial surgery, and 77.9% after repeated surgery with EBRT (p=<0.001). Acute toxicity was limited to grade I and II xerostomia, mucositis, and hoarseness; only one patient developed late grade III dysphagia. Conclusions: Postoperative EBRT is associated with long-lasting locoregional control and overall survival with acceptable toxicity in patients with locally advanced IR-DTC, especially in microscopic residual disease.

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“…To put this in broader perspective, the improvement in survival may even in part relate to the increasing incidence of HPV-induced OPSCC and associated favorable prognosis [ 4 ]. Hence, the advances in clinical management apparently do not directly translate into survival benefits, although improved function and quality of life are reported and are important as well [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Resection Margins in Head and Neck Cancer Surgery: An Update of Residual Disease and Field Cancerization

Pierik

Leemans

Brakenhoff

2021

Cancers

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Surgery is one of the mainstays of head and neck cancer treatment, and aims at radical resection of the tumor with 1 cm tumor-free margins to obtain locoregional control. Surgical margins are evaluated by histopathological examination of the resection specimen. It has been long an enigma that approximately 10–30% of surgically treated head and neck cancer patients develop locoregional recurrences even though the resection margins were microscopically tumor-free. However, the origins of these recurrences have been elucidated by a variety of molecular studies. Recurrences arise either from minimal residual disease, cancer cells in the surgical margins that escape detection by the pathologist when examining the specimen, or from precancerous mucosal changes that may remain unnoticed. Head and neck tumors develop in mucosal precursor changes that are sometimes visible but mostly not, fueling research into imaging modalities such as autofluorescence, to improve visualization. Mostly unnoticed, these precancerous changes may stay behind when the tumor is resected, and subsequent malignant progression will cause a local relapse. This led to a clinical trial of autofluorescence-guided surgery, of which the results were reported in 2020. This review focuses on the most recent literature of the improved diagnosis of the resection margins of surgically treated head and neck cancer patients, the pathobiological origin of recurrent disease, and relevant biomarkers to predict local relapse. Directions for further research will be discussed, including potential options for improved and personalized treatment, based on the most recently published data.

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Health-related quality of life and overall survival: a prospective study in patients with head and neck cancer treated with radiotherapy

Cited by 17 publications

References 47 publications

Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery

Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery

Postoperative external beam radiotherapy for locoregional control in iodine refractory differentiated thyroid cancer

Resection Margins in Head and Neck Cancer Surgery: An Update of Residual Disease and Field Cancerization

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