title: Quality of life, functional outcome, and costs of early glottic cancer.
abstract: OBJECTIVE
  To analyze quality of life, functional outcome, and hidden costs by primary treatment with surgery or radiation therapy in patients with early glottic cancer.
  
  
  METHODS
  Retrospective study in a tertiary care facility.
  
  
  METHODS
  A group of 101 patients with carcinoma in situ and T1 invasive squamous cell carcinoma treated primarily with either surgery or radiation, between January 1990 and December 2000, were identified from searching our tumor registry. Patients completed two previously validated questionnaires and one local questionnaire. Statistical significance was assessed with the rank sum test, chi2 test, or Fisher's Exact test.
  
  
  RESULTS
  Questionnaires were completed in 59% (44 of 74) of the surgical cohort and 41% (11 of 27) of the radiation therapy cohort. The primary surgical treatments were endoscopic excision (86%), hemilaryngectomy (12%), and total laryngectomy (1%). Patient-reported problems with swallowing, chewing, speech, taste, saliva, pain, activity, recreation, and appearance showed no difference between the endoscopic excision or radiation therapy cohorts. Comparing endoscopic excision versus radiation therapy, respectively, median number of treatments (2 vs. 35), total median travel distance (150 vs. 660 miles), total median travel time (180 vs. 1440 min), and total median number of hours of work missed (76 vs. 24) all differed significantly (P <.01).
  
  
  CONCLUSIONS
  Almost all patients with early glottic cancer, whether treated with surgery or radiation therapy, reported excellent quality of life outcomes and functional results. In addition to actual costs, the hidden costs for radiation therapy versus endoscopic excision were all greater in terms of total number of hours of work missed, total travel time, and total travel distance.
authors.affiliation: Department of Otolaryngology, University of Pittsburgh Medical Center, Pennsylvania 15213, USA. JCSmith@pitt.edu
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Smith
authors.forename: Jonas T
authors.initials: JT
authors.lastname: Johnson
authors.forename: David M
authors.initials: DM
authors.lastname: Cognetti
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Landsittel
authors.forename: William E
authors.initials: WE
authors.lastname: Gooding
authors.forename: Elmer R
authors.initials: ER
authors.lastname: Cano
authors.forename: Eugene N
authors.initials: EN
authors.lastname: Myers
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002278:Carcinoma in Situ / Q000191:economics / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000191:economics / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015331:Cohort Studies; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000191:economics* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D007825:Laryngectomy / Q000379:methods / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life; D011878:Radiotherapy / Q000379:methods / Q000523:psychology*; D012042:Registries; D011795:Surveys and Questionnaires; D016896:Treatment Outcome