Ronald C Eldridge1, Stephanie L Pugh2, Andy Trotti3, Kenneth Hu4, Sharon Spencer5, Sue S Yom6, David Rosenthal7, Nancy Read8, Anand Desai9, Elizabeth Gore10, George Shenouda11, Mark V Mishra12, Deborah Bruner1, Canhua Xiao1. 1. Emory University/Winship Cancer Center, Atlanta, Georgia. 2. NRG Oncology Statistics and Data Management Center, Pittsburgh, Pennsylvania. 3. Moffitt Cancer Center, Tampa, Florida. 4. Laura and Isaac Perlmutter Cancer Center at NYU Langone, New York, New York. 5. University of Alabama at Birmingham Medical Center, Birmingham, Alabama. 6. UCSF Medical Center-Mount Zion, San Francisco, California. 7. University of Texas MD Anderson Cancer Center, Houston, Texas. 8. London Regional Cancer Program, London, Ontario, Canada. 9. Akron City Hospital, Akron, Ohio. 10. Zablocki VA Medical Center (Accruals under Froedtert and the Medical College of Wisconsin), Milwaukee, Wisconsin. 11. McGill University, Montreal, Quebec, Canada. 12. University of Maryland/Greenebaum Cancer Center, Baltimore, Maryland.
Abstract
BACKGROUND: Is posttreatment functional status prognostic of overall survival in patients with head and neck cancer (HNC). METHODS: In an HNC clinical trial, 495 patients had two posttreatment functional assessments measuring diet, public eating, and speech within 6 months. Patients were grouped by impairment (highly, moderately, modestly, or not impaired) and determined if they improved, declined, or did not change from the first assessment to the second. Multivariable Cox models estimated overall mortality. RESULTS: Across all three scales, the change in posttreatment patient function strongly predicted overall survival. In diet, patients who declined to highly impaired had three times the mortality of patients who were not impaired at both assessments (hazard ratio [HR] = 3.60; 95% confidence interval, 2.02-6.42). For patients improving from highly impaired, mortality was statistically similar to patients with no impairment (HR = 1.38; 95% CI, 0.82-2.31). CONCLUSIONS: Posttreatment functional status is a strong prognostic marker of survival in patients with HNC.
RCT Entities:
BACKGROUND: Is posttreatment functional status prognostic of overall survival in patients with head and neck cancer (HNC). METHODS: In an HNC clinical trial, 495 patients had two posttreatment functional assessments measuring diet, public eating, and speech within 6 months. Patients were grouped by impairment (highly, moderately, modestly, or not impaired) and determined if they improved, declined, or did not change from the first assessment to the second. Multivariable Cox models estimated overall mortality. RESULTS: Across all three scales, the change in posttreatment patient function strongly predicted overall survival. In diet, patients who declined to highly impaired had three times the mortality of patients who were not impaired at both assessments (hazard ratio [HR] = 3.60; 95% confidence interval, 2.02-6.42). For patients improving from highly impaired, mortality was statistically similar to patients with no impairment (HR = 1.38; 95% CI, 0.82-2.31). CONCLUSIONS: Posttreatment functional status is a strong prognostic marker of survival in patients with HNC.
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