Health related quality of life following the treatment of oropharyngeal cancer by transoral laser.
In 2006, our Institution changed the treatment strategy for small volume primary oropharyngeal tumours to transoral laser microsurgery (TOLM). The main aim of this cohort study was to report the health related quality of life (HRQOL) at around 2 years following TOLM in consecutive patients treated from July 2006 through April 2013. The University of Washington Quality of Life (UW-QOL) questionnaire was administered annually up to Spring 2014 and adjusting for mortality the overall response rate was 71 % (108/153). Tonsil primary site characterised 60 % (98) of patients, base of tongue 25 % (40), soft palate 13 % (21) and others 2 %, (3). Most patients had TOLM, neck dissection and adjuvant radiotherapy, with 21 % (34) of tumours at stage 1 or 2, 25 % (40) at stage 3 and 54 % (88) at stage 4. Kaplan-Meier estimates of overall survival were 94 % at 1 year, 88 % at 2 years and 68 % at 5 years after TOLM. Three-quarters (76 %) reported their overall QOL as being good, very good or outstanding, and by domain a clear majority of patients (range 57-94 %, median 79 %) reported none or only minor problems, most notably for swallowing, chewing and speech. The main dysfunction was in saliva (39 %). In conclusion, the outcomes in TOLM for oropharyngeal squamous cell carcinoma are very encouraging. The data supports the current treatment strategy in the Unit. Further outcomes research is required to help refine patient selection to help optimise the survival and HRQOL benefit of TOLM.
Evidence-Based Practice Research Centre (EPRC), Faculty of Health and Social Care, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK. snrogers.aintree@gmail.com.|Head and Neck Unit, University Hospital Aintree, Liverpool, L9 1AE, UK. snrogers.aintree@gmail.com.|Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 1AE, UK. snrogers.aintree@gmail.com.
S N
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Rogers
Royal Liverpool University Hospital, Liverpool, L7 8XP, UK.
R S
RS
Pinto
Head and Neck Unit, University Hospital Aintree, Liverpool, L9 1AE, UK.
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Lancaster
Head and Neck Unit, University Hospital Aintree, Liverpool, L9 1AE, UK.|Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 1AE, UK.
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Bekiroglu
Evidence-Based Practice Research Centre (EPRC), Faculty of Health and Social Care, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK.|Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 1AE, UK.
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Lowe
Head and Neck Unit, University Hospital Aintree, Liverpool, L9 1AE, UK.
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Tandon
Head and Neck Unit, University Hospital Aintree, Liverpool, L9 1AE, UK.|Liverpool University Molecular Science, Liverpool, L7 8XP, UK.
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Jones
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003679:Deglutition / Q000502:physiology; D005260:Female; D006304:Health Status; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008409:Mastication; D008866:Microsurgery; D008875:Middle Aged; D037981:Neck Dissection; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D012463:Saliva; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
Health related quality of life; Oropharyngeal cancer; Patient reported outcomes; Transoral laser resection