title: Vocal handicap and quality of life after treatment of advanced squamous carcinoma of the larynx and/or hypopharynx.
abstract: OBJECTIVE
  To evaluate and correlate voice-specific quality of life (QOL) and health-related QOL (HR-QOL) after treatment for advanced cancer of the larynx and/or hypopharynx.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Patients submitted to partial laryngectomy (PL), salvage PL (sPL), concomitant radiotherapy and chemotherapy (RT+Chemo), total laryngectomy (TL), salvage TL (sTL), total pharyngolaryngectomy (TP) and salvage total pharyngolaryngectomy (sTP). The following questionnaires were used: (1) Voice Handicap Index (VHI) and (2) University of Washington Quality of Life Questionnaire (UW-QOL; version 4).
  
  
  RESULTS
  Eighty-four patients participated in the study. All the patients PL (10), sPL (1), and RT+Chemo (24) communicated by laryngeal voice. Of the 49 patients submitted to total removal of the larynx, 30 communicated with alaryngeal phonation, the major part being tracheoesophageal prosthesis (17). The worst subscale of VHI for the total patient group was functional (mean=13.15), and the value of the total score was 31. Patients submitted to PL, RT+Chemo, and TL presented slight handicap (medians of 27, 14, and 21.5, respectively). Patients treated with sTL, TP, and sTP presented moderate handicap (medians of 45, 37.5, and 31.5, respectively). HR-QOL was considered between good and excellent for 78.6% of the patients, and poor for 21.4%. The correlation between voice-specific QOL and HR-QOL was significant (P=0.0001).
  
  
  CONCLUSIONS
  Patients treated for advanced cancer of the larynx/hypopharynx present slight to moderate voice handicap and good/excellent HR-QOL. Stricter analysis of both the VHI and UW-QOL data suggests that more attention be given to the vocal handicap of the individual patient.
authors: Department of Voice, Speech and Swallowing Rehabilitation, Hospital A. C. Camargo, São Paulo, Brazil.
authors: Elma Heitmann Mares
authors: EH
authors: Azevedo
authors: Neyller
authors: N
authors: Montoni
authors: João
authors: J
authors: Gonçalves Filho
authors: Luiz Paulo
authors: LP
authors: Kowalski
authors: Elisabete
authors: E
authors: Carrara-de Angelis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000628:therapy*; D007822:Laryngeal Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014832:Voice Disorders / Q000453:epidemiology*