title: Quality of life after transoral laser microresection of laryngeal cancer: a longitudinal study.
abstract: METHODS
  In the treatment of early to moderate laryngeal carcinoma, both, transoral laser surgery and radiation-based protocols have demonstrated good survival and preservation rates. In this scenario, quality of life (QOL) may become an important tool for treatment planning. We aimed to evaluate QOL changes after transoral laser microsurgery (TLM). Prospective longitudinal study. Ninety-three consecutive disease-free patients were evaluated using UW-QOL v4 and SF-12, before and 12 months after treatment. Changes over time were assessed according to age, gender, location, tumor size, and adjuvant treatment.
  
  
  RESULTS
  UW-QOL improved from 1,051.5 ± 133.7 to 1,121.7 ± 92.1 (P = 0.000), suggesting that the impact of the treatment was favorable in most of the patients. Voice quality significantly improved after TLM, but speech was still the most important variable for 46% of the patients. Tumor location (P = 0.002) was an independent factor for preoperative total score of UW-QOL, whereas adjuvant radiation (P = 0.03) and neck dissection (P = 0.02), were the only postoperative negative factors.
  
  
  CONCLUSIONS
  One year after TLM patients present a very good QOL. Relevant voice impairment is detected especially in locally advanced tumors, reinforcing the necessity of preoperative counseling and postoperative rehabilitation. Adjuvant radiotherapy and neck dissection negatively influenced disease-specific QOL.
authors.affiliation: Department of Otolaryngology, Hospital Clínic, Barcelona, Spain. ivila@clinic.ub.es
authors.forename: Isabel
authors.initials: I
authors.lastname: Vilaseca
authors.forename: Ferran
authors.initials: F
authors.lastname: Ballesteros
authors.forename: Brígida Meritxell
authors.initials: BM
authors.lastname: Martínez-Vidal
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lehrer
authors.forename: Manuel
authors.initials: M
authors.lastname: Bernal-Sprekelsen
authors.forename: José Luis
authors.initials: JL
authors.lastname: Blanch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D053685:Laser Therapy; D008137:Longitudinal Studies; D008866:Microsurgery; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection / Q000009:adverse effects; D011446:Prospective Studies; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D013060:Speech; D014833:Voice Quality