Anh The Bui1, Keven Seung Yong Ji2, Canh Tuan Pham1, Ky Minh Le1, Thang Xuan Tong1, Walter Tsong Lee3. 1. Department of Head and Neck Surgery, National ENT Hospital of Vietnam, Hanoi, Viet Nam. 2. Duke University School of Medicine, Durham, NC, USA. 3. Duke University School of Medicine, Durham, NC, USA; Section of Otolaryngology, Durham VA Medical Center, Durham, NC, USA; Division of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC, USA. Electronic address: walter.lee@duke.edu.
Abstract
BACKGROUND: There is insufficient prospective data on quality of life outcomes for laryngeal cancer patients undergoing surgery, especially in low- and middle-income countries. This limits clinical and patient decision-making, and survivorship expectations. This research aimed to define longitudinal changes in quality of life in patients with laryngeal cancer from the pre-operative to post-operative period. MATERIALS AND METHODS: A prospective cohort with primary laryngeal cancer treated with standard-of-care surgery who have completed a minimum follow-up of 1 year were evaluated. Patients underwent one of three standard-of-care surgical treatments: transoral laser microsurgery, open partial laryngectomy and total laryngectomy. Patients completed the EORTC-C30 quality of life questionnaire and associated Head and Neck module (EORTC-H&N35) pre- and post-operatively at 1, 3, 6, and 12 months. Global, functional- and symptom-related domains were assessed. RESULTS: 140 patients participated in the study (135 males and 5 females, mean [SD] age 57.0 [7.8] years). Patients were grouped based on primary surgical treatment: (Group 1-transoral laser microsurgery; Group 2-open partial laryngectomy; Group 3-total laryngectomy). In Group 1, a significant decline at 3 months was reported in all five functional scales and five symptom scales: speech, social eating, cough, appetite, and fatigue. In Group 2, significant decline at 1 month post-operative period was seen in the global health scale, all five functional scales and six symptom scales: speech, social eating, cough, appetite, sexuality, and feeling ill. In Group 3, significant decline without return to baseline was seen in the global health scale, all five functional scales and six symptom scales: speech, sense, cough, sticky saliva, sexuality, and social contact. These scores were lowest at 1 month post-op. CONCLUSIONS: Significant changes in quality of life domains after laryngeal cancer surgery were identified. This research provides critical information for improving clinical and patient decision-making and for informing survivorship expectations for those undergoing surgery for laryngeal cancer.
BACKGROUND: There is insufficient prospective data on quality of life outcomes for laryngeal cancerpatients undergoing surgery, especially in low- and middle-income countries. This limits clinical and patient decision-making, and survivorship expectations. This research aimed to define longitudinal changes in quality of life in patients with laryngeal cancer from the pre-operative to post-operative period. MATERIALS AND METHODS: A prospective cohort with primary laryngeal cancer treated with standard-of-care surgery who have completed a minimum follow-up of 1 year were evaluated. Patients underwent one of three standard-of-care surgical treatments: transoral laser microsurgery, open partial laryngectomy and total laryngectomy. Patients completed the EORTC-C30 quality of life questionnaire and associated Head and Neck module (EORTC-H&N35) pre- and post-operatively at 1, 3, 6, and 12 months. Global, functional- and symptom-related domains were assessed. RESULTS: 140 patients participated in the study (135 males and 5 females, mean [SD] age 57.0 [7.8] years). Patients were grouped based on primary surgical treatment: (Group 1-transoral laser microsurgery; Group 2-open partial laryngectomy; Group 3-total laryngectomy). In Group 1, a significant decline at 3 months was reported in all five functional scales and five symptom scales: speech, social eating, cough, appetite, and fatigue. In Group 2, significant decline at 1 month post-operative period was seen in the global health scale, all five functional scales and six symptom scales: speech, social eating, cough, appetite, sexuality, and feeling ill. In Group 3, significant decline without return to baseline was seen in the global health scale, all five functional scales and six symptom scales: speech, sense, cough, sticky saliva, sexuality, and social contact. These scores were lowest at 1 month post-op. CONCLUSIONS: Significant changes in quality of life domains after laryngeal cancer surgery were identified. This research provides critical information for improving clinical and patient decision-making and for informing survivorship expectations for those undergoing surgery for laryngeal cancer.
Authors: Oreste Gallo; Chiara Bruno; Luca Giovanni Locatello; Federica Martelli; Maria Cilona; Pietro Orlando; Giuseppe Fancello; Giandomenico Maggiore; Francesca Viberti; Pierguido Ciabatti; Simone Boccuzzi; Marco Mandalà Journal: Support Care Cancer Date: 2021-04-15 Impact factor: 3.603