Quality of life in patients with head and neck cancer: lessons learned from 549 prospectively evaluated patients.
OBJECTIVE
To summarize our quality-of-life (QOL) research findings for patients with head and neck cancer, to suggest areas for future productive QOL research, and to discuss how to undertake QOL studies in a cost-effective manner.


METHODS
Review of previously published analyses of advanced larynx cancer, advanced oropharynx cancer, and neck-dissection cases and current data from the complete set of patients.


METHODS
From January 1, 1993, through December 31, 1998, data on 549 patients were entered in our head and neck database. Of these patients, 364 met additional criteria for histologic findings (squamous cell carcinoma) and the restriction of their cancer to 4 major anatomical sites (oral, oropharynx, hypopharynx, or larynx). Of these, 339 patients were more than 1 year beyond initial treatment. Complete baseline TNM staging and QOL data were obtained for 260 of these patients, of whom 210 presented with an untreated first primary tumor (index cases) to the University of Washington, Seattle.


METHODS
Pretreatment QOL was assessed with an interviewer-supervised self-administered questionnaire. Subsequent self-administered tests were completed at 3, 6, 12, 24, and 36 months. Other data collected on each patient included cancer site, stage, treatment, histologic findings, type of surgical reconstruction, and current disease and vital status.


CONCLUSIONS
It is difficult to achieve "statistically significant" results in a single-institution setting. The "composite" QOL score may not be a sufficiently sensitive tool. Analysis of separate domains may be more effective.
Weymuller
E A
EA
Department of Otolaryngology--Head and Neck Surgery, University of Washington School of Medicine, Seattle 98195, USA. eaw@u.washington.edu
Yueh
B
B
Deleyiannis
F W
FW
Kuntz
A L
AL
Alsarraf
R
R
Coltrera
M D
MD
D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D037981:Neck Dissection; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology*; D011788:Quality of Life; D018434:Sickness Impact Profile