Learnings From Longitudinal Patient-Reported and Clinical Outcomes in Palliative Head and Neck Cancer Care

Otolaryngol Head Neck Surg. 2023 Aug;169(2):294-302. doi: 10.1177/01945998221127203. Epub 2023 Jan 29.

Abstract

Objective: Patients with palliative head and neck cancer experience many symptoms in a short period of time. Longitudinal data on patient-reported outcomes in this phase are lacking. The aim of this study is to use structurally obtained patient-reported outcome data combined with clinical patient data and obtain insight in patient-reported outcomes, survival, circumstances of death, and interventions and treatment during the palliative phase in order to improve the quality of end-of-life care and patient-centered counseling.

Study design: Longitudinal observational cohort study.

Setting: Tertiary cancer center.

Method: Quality of life was prospectively collected using the European Organization for Research and Treatment of Cancer QLQ-C15-PAL. Tumor- and patient-specific data were retrospectively collected. Descriptive statistics, linear mixed models, and regression analyses were performed.

Results: A significant deterioration was found in global health status, physical functioning, fatigue, dyspnea, appetite loss, and constipation over time. However, emotional functioning improved. Median survival was 5.1 months, and only a low percentage of in-hospital death was observed (7.8%). Higher global health status at intake was associated with prolonged survival.

Conclusion: Structural measurement of patient-reported outcome together with clinical outcomes provides unique insight, which enables improvement of patient-centered counseling and care.

Keywords: head and neck cancer; longitudinal studies; palliative care; patient-centered care; patient-reported outcome measures.

Publication types

  • Observational Study

MeSH terms

  • Head and Neck Neoplasms* / complications
  • Head and Neck Neoplasms* / therapy
  • Hospital Mortality
  • Humans
  • Neoplasms* / complications
  • Palliative Care
  • Patient Reported Outcome Measures
  • Quality of Life / psychology
  • Retrospective Studies
  • Surveys and Questionnaires