title: Outcomes analysis of voice and quality of life in patients with laryngeal cancer.
abstract: OBJECTIVE
  To assess relationships between voice satisfaction and global quality of life in patients who have been treated for laryngeal cancer.
  
  
  METHODS
  Cross-sectional survey study.
  
  
  METHODS
  Veterans Affairs Medical Center.
  
  
  METHODS
  Eighty patients who had completed treatment for laryngeal cancer with either total laryngectomy (n=17), radiotherapy (n=24), or both (n=39).
  
  
  METHODS
  Subscale scores on a general health status instrument (the Medical Outcomes Study 36-item short-form health survey), and a validated voice-specific functional status instrument (the Voice Handicap Index).
  
  
  RESULTS
  Self-rated global health did not correlate significantly with emotional, functional, or physical voice handicap, although some subscales on the 36-item short-form health survey correlated with voice handicap scores. Global health status scores did not differ between patients who had undergone laryngectomy with a tracheoesophageal puncture and patients treated with radiotherapy only. Physical voice handicap scores did not differ significantly between those who underwent tracheoesophageal puncture and those who had radiotherapy, but emotional (P=.07) and functional (P=.01) handicap scores were lower in patients treated with radiotherapy. However, there was considerable overlap in voice handicap scores, with many patients who had had tracheoesophageal puncture showing less voice handicap than patients treated with radiotherapy.
  
  
  CONCLUSIONS
  These data demonstrate that health status is affected by other factors than voice handicap in patients with laryngeal cancer. In addition, there is a large amount of individual variation in voice handicap after treatment. These findings illustrate the need for prospective studies assessing voice handicap and quality of life after treatment for laryngeal cancer.
authors.affiliation: Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Tex 77030, USA. mgstew@bcm.tmc.edu
authors.forename: M G
authors.initials: MG
authors.lastname: Stewart
authors.forename: A Y
authors.initials: AY
authors.lastname: Chen
authors.forename: C B
authors.initials: CB
authors.lastname: Stach
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D006304:Health Status; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy* / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D014832:Voice Disorders / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation*; D014833:Voice Quality