title: Long-term health-related quality of life in survivors of head and neck cancer.
abstract: OBJECTIVE
  To examine health-related quality of life (HRQOL) reported by 5-year head and neck cancer survivors and factors that predicted these long-term scores.
  
  
  METHODS
  Prospective, observational outcomes study.
  
  
  METHODS
  Tertiary care institution.
  
  
  METHODS
  A total of 337 patients diagnosed as having head and neck carcinoma between January 1995 and December 2004, who enrolled in the Outcomes Assessment Project and survived at least 5 years.
  
  
  METHODS
  While participating in the longitudinal Outcomes Assessment Project, patients filled out surveys measuring HRQOL at numerous points in time.
  
  
  METHODS
  Outcomes included 5-year scores in eating, speech, aesthetics, social disruption, physical and mental health, depressive symptoms, and overall quality of life (QOL). In addition to analyzing patients' 5-year HRQOL outcomes, multivariate analyses were performed to determine which patient, clinical, treatment, and 1-year HRQOL factors independently predicted these 5-year outcomes.
  
  
  RESULTS
  Overall, the cohort's long-term general health was similar to that to age-matched norms from the general population. But over 50% of these survivors had problems eating, 28.5% reported depressive symptoms, and 17.3% reported substantial pain. At long-term follow-up, 13.6% continued to smoke, and 38.9% used alcohol. Multivariate analyses demonstrated that 1-year pain and diet were the strongest independent predictors of 5-year HRQOL outcomes.
  
  
  CONCLUSIONS
  Eating problems due to poor oropharyngeal functioning and persistent pain are the most prevalent problems that these survivors face. Early interventions addressing eating issues, swallowing problems, and pain management will be a crucial component in improving this patient population's long-term QOL, especially in those who are functioning poorly 1 year after diagnosis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA. gerry-funk@uiowa.edu
authors.forename: Gerry F
authors.initials: GF
authors.lastname: Funk
authors.forename: Lucy Hynds
authors.initials: LH
authors.lastname: Karnell
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Christensen
mesh_terms: D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D017741:Survivors / Q000523:psychology*