Health-related quality of life scores in long-term head and neck cancer survivors predict subsequent survival: a prospective cohort study

Clin Otolaryngol. 2011 Aug;36(4):361-8. doi: 10.1111/j.1749-4486.2011.02342.x.

Abstract

Objective: To examine the survival prediction of long-term health-related quality of life in patients with head and neck squamous cell carcinoma.

Design: Patients with head and neck squamous cell carcinoma diagnosed in the period between July 1992 and October 2001, who had been disease free for a minimum of 1 year following therapy, responded to structured interviews including several validated questionnaires in the period from October 2002 to March 2004. The study ended in June 2009 with a mean observation time of 75 ± 4 months among the survivors. Twenty-four deaths were observed.

Setting: University hospital, referral centre of the Western Norway.

Participants: One hundred and thirty-nine cognitive functioning patients.

Main outcome measurements: Overall survival as of June 2009. This was correlated with various clinical factors and the EORTC QLQ-C30 questionnaire, the Eysenck Personality Inventory and the Coping inventory completed between October 2001 and March 2004.

Results: A general symptom sum score was significantly predictive of survival directly and after sequential adjustment for self-reported levels of neuroticism, avoidance focused coping, coping by suppression of competing activity, alcohol consumption, smoking status and heart/lung disease, as well as gender, age, time between diagnosis and inclusion, tumour node metastasis (TNM) stage and tumour site. Similar results were found for the health-related quality of life indices 'fatigue', 'dyspnoea' and 'sleep disturbance'. A dichotomised variable based on the general symptom sum score was calculated, and a high risk group, as to mortality, including less than a quintile of the total patient population was established. A hazard ratio of 5.15 was found for the dichotomised general symptom sum score.

Conclusion: We have shown a unique and independent survival prediction from long-term EORTC QLQ-C30 scores in successfully treated and cognitive functioning head and neck squamous cell carcinoma patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / psychology*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / psychology*
  • Humans
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Prognosis
  • Prospective Studies
  • Quality of Life*
  • Surveys and Questionnaires*
  • Survival Rate / trends
  • Survivors / psychology*
  • Survivors / statistics & numerical data