title: Quality of life before and after total laryngectomy: results of a multicenter prospective cohort study.
abstract: BACKGROUND
  The purpose of this study was to determine what quality of life (QOL) areas improve and deteriorate during the first year after total laryngectomy and to identify predictors of these changes.
  
  
  METHODS
  One hundred seventy-four patients completed the European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaires before laryngectomy, n = 133 before discharge from hospital, n = 110 at the end of rehabilitation, and n = 86 1 year after laryngectomy. Multivariate regression analysis was performed to estimate the effect of potential predictors on QOL.
  
  
  RESULTS
  Areas that did not recover to baseline level were physical functioning, role functioning, social functioning, fatigue, dyspnea, appetite loss, financial difficulties, senses, speech, and social contact, whereas global health status, coughing, and weight improved. There was no evidence for predicting effects of age, sex, education, and tumor site. Tumor stage, recurrent disease, radiotherapy, and mental health did display predicting effects. Smoking status before the treatment had marginally significant effects.
  
  
  CONCLUSIONS
  QOL decreases initially after laryngectomy; some QOL areas recover slowly over the course of the year after surgery, and some remain significantly worse than at baseline.
authors.affiliation: University Medical Centre Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Mainz, Germany; University of Leipzig, Division of Psychosocial Oncology, Leipzig, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.forename: Helge
authors.initials: H
authors.lastname: Danker
authors.forename: Orlando
authors.initials: O
authors.lastname: Guntinas-Lichius
authors.forename: Jens
authors.initials: J
authors.lastname: Oeken
authors.forename: Friedemann
authors.initials: F
authors.lastname: Pabst
authors.forename: Juliane
authors.initials: J
authors.lastname: Schock
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Vogel
authors.forename: Eberhard F
authors.initials: EF
authors.lastname: Meister
authors.forename: Cornelia
authors.initials: C
authors.lastname: Wulke
authors.forename: Andreas
authors.initials: A
authors.lastname: Dietz
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life
keywords: EORTC QLQ-H&N35; head and neck cancer; laryngectomy; longitudinal study; prospective study; quality of life