title: Prediction of 5 year survival from level of perceived distress in newly diagnosed head and neck squamous cell carcinoma patients.
abstract: OBJECTIVE
  To evaluate the predictive effect of level of perceived distress on survival in a cohort of newly diagnosed head and neck squamous cell carcinoma (HNSCC) patients.
  
  
  METHODS
  One hundred and one (N=101) consecutive HNSCC patients self-reported their levels of distress, measured with the general health questionnaire 30 (GHQ-30) at the time of diagnosis. All included patients were younger than 78years of age, cognitive adequate functioning, and scheduled for curative treatment. At the time of diagnosis self-reported levels of neuroticism, problem and avoidance focused coping, smoking and alcohol consumption, and sociodemographic information were registered. Clinical characteristics and comorbidities were determined from the patient hospital records.
  
  
  RESULTS
  The 5-year overall survival of the cohort was 68.3%. Thirty-two deaths occurred during the 5-year observation period. The Likert analyzed GHQ sum score, as well as a dichotomized GHQ score were found to predict survival in univariate Cox proportional hazards regression analyses. The hazard ratios were 1.04 (p=.04) and 2.78 (p=.01), respectively. The predictive effect of the GHQ scores remained significant throughout sequential multivariate analyses with adjustments for all the above mentioned covariates. Even a post hoc analysis including all covariates demonstrated an evident survival prediction.
  
  
  CONCLUSIONS
  Self-reported distress measured pretreatment in newly diagnosed HNSCC patients predict survival. Further studies are warranted to elucidate mechanisms and possible interventions.
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, N-5020 Bergen, Norway; Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, 5021 Bergen, Norway. Electronic address: arild.osthus@gmail.com.
authors.forename: Arild Andrè
authors.initials: AA
authors.lastname: Østhus
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, 5021 Bergen, Norway; Haraldsplass Deaconal University College, Bergen, Norway.
authors.forename: Anne Kari H
authors.initials: AKH
authors.lastname: Aarstad
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, 5021 Bergen, Norway.
authors.forename: Jan
authors.initials: J
authors.lastname: Olofsson
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, N-5020 Bergen, Norway; Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, 5021 Bergen, Norway.
authors.forename: Hans Jørgen
authors.initials: HJ
authors.lastname: Aarstad
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000523:psychology; D006801:Humans; D008297:Male; D013315:Stress, Psychological; D015996:Survival Rate
keywords: GHQ; Head and neck cancer; Psychological distress; Survival