title: The association between health related quality of life and survival in patients with head and neck cancer: a systematic review.
abstract: The aim of this study was to systematically review available evidence on the association between health-related quality of life (HRQoL) and survival in patients with head and neck cancer (HNC), adjusted for important clinical, demographic and lifestyle-related factors. A systematic literature search in four electronic bibliographic databases was conducted in January 2014. We included studies that provided data on HRQoL, survival, and the association between HRQoL and survival among HNC patients. Two researchers independently rated the quality of the included studies. A best evidence synthesis was applied to draw conclusions. Nineteen studies were included, of which twelve focused on all subscales of a HRQoL questionnaire and seven focused on selected subscales. The mean (SD) quality score was 72 (17)% and 11 (58)% studies were of high quality. According to the best evidence synthesis, we found strong evidence for a positive association between pre-treatment physical functioning and survival and between change in global QoL from pre-treatment to 6 months after treatment and survival. Due to inconsistent findings, we found insufficient evidence for an association with survival of other HRQoL domains, including role, emotional, cognitive and social functioning, mental health and well-being. Future high quality studies with a longitudinal design are needed to examine the complex association between HRQoL and survival.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Annette J
authors.initials: AJ
authors.lastname: van Nieuwenhuizen
authors.affiliation: Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Laurien M
authors.initials: LM
authors.lastname: Buffart
authors.affiliation: Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: C René
authors.initials: CR
authors.lastname: Leemans
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: im.verdonck@vumc.nl.
authors.forename: Irma M
authors.initials: IM
authors.lastname: Verdonck-de Leeuw
mesh_terms: D006258:Head and Neck Neoplasms / Q000503:physiopathology*; D006801:Humans; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016019:Survival Analysis
keywords: Best evidence synthesis; Head and neck neoplasm; Health-related quality of life; Quality assessment; Survival; Systematic review