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EORTC Quality of Life Questionnaire Head and Neck (H&N)-35 scores from H&N squamous cell carcinoma patients obtained at diagnosis and at 6, 9 and 12 months following diagnosis predict 10-year overall survival

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Abstract

Purpose

To study the 10-year overall survival predictions, and mechanisms behind, of head and neck (HN) quality of life (QoL) scores obtained at diagnosis and 6, 9, and 12 months following diagnosis in a cohort of HN squamous cell carcinoma (HNSCC) patients.

Methods

Consecutive HNSCC patients (N = 109) subjected to standard workup and treatment self-reported their QoL measured by the EORTC Quality of Life Questionnaire (QLQ) H&N-35 between November 2002 and June 2005. Each QoL index was calculated and additionally aggregated to one sum score. The included patients were at diagnosis younger than 78 years, judged adequately cognitive functioning, and scheduled for curative treatment. Self-reported smoking, alcohol consumption, and socio-demographic information were registered. Twenty-two patients were high-risk (hr)-HPV DNA tumor positive. If the treatment goal was changed to palliative, no new QoL information was collected. All living patients were followed until 10 years after diagnosis.

Results

Median survival was 105 months. Significant overall survival predictions were found from the EORTC H&N-35 QLQ sum scores continuously measured at diagnosis (p = 0.006) and obtained at 6 (p = 0.02), 9 (p = 0.002) and 12 (p = 0.05) months. Lower QoL predicted lower overall survival. These sum score survival predictions were in part independent of TNM stage, hr-HPV status, gender, age, alcohol and smoking status. The indices “pain”, “swallowing”, “social eating”, and “feeling ill” were predictive of survival at 3 out of 4 measuring points (diagnosis, 6, 9 and 12 months) in univariate analyses.

Conclusion

EORTC H&N-35 QLQ scores at diagnosis and throughout the first year thereafter harbor prognostic power.

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Funding

This work has been supported by the Norwegian Cancer Society.

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Authors and Affiliations

  1. Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway

    Hans Jørgen Aarstad, Helene Hersvik Aarstad & Stein Lybak

  2. Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, 5021, Bergen, Norway

    Hans Jørgen Aarstad, Stein Lybak & Anne Kari H. Aarstad

  3. Department of Otorhinolaryngology, Oslo University Hospital-Rikshospitalet, Oslo, Norway

    Arild Andrè Østhus

  4. Faculty of Health, VID Specialized University, Bergen, Norway

    Anne Kari H. Aarstad

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  1. Hans Jørgen Aarstad
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Correspondence to Hans Jørgen Aarstad.

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Aarstad, H.J., Østhus, A.A., Aarstad, H.H. et al. EORTC Quality of Life Questionnaire Head and Neck (H&N)-35 scores from H&N squamous cell carcinoma patients obtained at diagnosis and at 6, 9 and 12 months following diagnosis predict 10-year overall survival. Eur Arch Otorhinolaryngol 276, 3495–3505 (2019). https://doi.org/10.1007/s00405-019-05630-2

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