title: The association of psycho-social factors and survival in head and neck cancer.
abstract: OBJECTIVE
  Update a previous review examining associations between psycho-social factors and survival in head and neck cancer patients.
  
  
  METHODS
  Searched Cochrane, Psych info and Embase for the period from 1 January 1995 to 1 June 2007, as well as personal and article reference lists and article archives.
  
  
  METHODS
  Identified articles assessed by consensus for eligibility using following criteria: survival as outcome measure; psycho-social factors as prognostic indicators; results specifically for head and neck cancer patients, not including oesophageal or thyroid cancer. Seven of 64 articles fulfilled criteria.
  
  
  METHODS
  Data abstracted independently by two reviewers using pre-determined proformas. Quality also rated using Scottish Intercollegiate Guidelines Network 50 tool.
  
  
  RESULTS
  At baseline, expression of intense psycho-social complaints, higher self-perceived physical ability and self-reported high physical functioning were significantly associated with increased survival. Uncertainty about the diagnosis and treatment was found to be a negative prognostic indicator, as was being single, poor cognitive function, baseline fatigue and alcoholism. Overall quality of life and head and neck pain 12 months after date of diagnosis were found to be significantly associated with survival in one study. However, overall quality of life and depression at the time of diagnosis were not.
  
  
  CONCLUSIONS
  There appears to be some association between selected psycho-social factors and long-term survival from head and neck cancer. However this relationship is currently neither strong nor proven, requiring examination by multi centred trials with standardisation of research definitions and methodologies, and examination of post-treatment psycho-social factors.
authors.affiliation: Institute of Head and Neck Studies and Education, Department of Otolaryngology, University Hospitals Coventry and Warwick NHS Trust, Coventry, UK. hisham.mehanna@uhcw.nhs.uk
authors.forename: H M
authors.initials: HM
authors.lastname: Mehanna
authors.forename: M F
authors.initials: MF
authors.lastname: De Boer
authors.forename: R P
authors.initials: RP
authors.lastname: Morton
mesh_terms: D000223:Adaptation, Psychological; D003710:Demography; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000523:psychology* / Q000628:therapy; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D011584:Psychology; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D012944:Social Support; D011795:Surveys and Questionnaires; D015996:Survival Rate