Abstract
Objectives
To evaluate the 5- and 10-year survival prediction of health-related quality of life (HRQoL) scores obtained at diagnosis and at 6, 9 and 12 months after diagnosis in a cohort of curable head and neck squamous cell carcinoma (HNSCC) patients.
Materials and methods
HNSCC patients (n = 109) reported their HRQoL measured by the EORTC Quality of Life Questionnaire (QLQ) general (C30) questionnaire. At diagnosis, the included patients were below 78 years of age and at diagnosis planned treated with curative intent. Clinical variables and self-reported smoking, alcohol consumption and socio-demographic information were registered. From diagnostic blocks, we found 22 patients to be human papillomavirus (HPV) positive. New HRQoL scores were not obtained if the patient treatment changed from curative to palliative throughout the HRQoL data acquisition. Survival was determined from the National Population Register of Norway.
Results
Decreased survival with low HRQoL scores from EORTC QLQ scores was demonstrated with HRQoL scores obtained from different time points of the four time points studied. These survival predictions were mostly independent of HPV status, gender, age, TNM stage, tumor site, alcohol consumption, present smoking status and whether comorbidities were present at diagnosis; as well as to some extent with an adjustment of the same HRQoL score/index obtained at diagnosis. The specific indices “physical function”, “general pain” and “sleep disturbance” were in particular predictive of survival.
Conclusion
HRQoL scores obtained throughout the first year after diagnosis contained prognostic power to overall survival when measured both at 5 and 10 years of observation.
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References
Klein J, Livergant J, Ringash J (2014) Health related quality of life in head and neck cancer treated with radiation therapy with or without chemotherapy: a systematic review. Oral Oncol 50:254–262
Verdonck-de Leeuw IM, van Nieuwenhuizen A, Leemans CR (2012) The value of quality-of-life questionnaires in head and neck cancer. Curr Opin Otolaryngol Head Neck Surg 20:142–147
van Nieuwenhuizen AJ, Buffart LM, Brug J, Leemans CR, Verdonck-de Leeuw IM (2015) The association between health related quality of life and survival in patients with head and neck cancer: a systematic review. Oral Oncol 51:1–11
Montazeri A (2009) Quality of life data as prognostic indicators of survival in cancer patients: an overview of the literature from 1982 to 2008. Health Qual Life Outcomes 7:102
Forman D, de Martel C, Lacey CJ, Soerjomataram I, Lortet-Tieulent J et al (2012) Global burden of human papillomavirus and related diseases. Vaccine 30(Suppl 5):F12-23
Wang MB, Liu IY, Gornbein JA, Nguyen CT (2015) HPV-positive oropharyngeal carcinoma: a systematic review of treatment and prognosis. Otolaryngol Head Neck Surg 153:758–769
Ljokjel B, Lybak S, Haave H, Olofsson J, Vintermyr OK et al (2014) The impact of HPV infection on survival in a geographically defined cohort of oropharynx squamous cell carcinoma (OPSCC) patients in whom surgical treatment has been one main treatment. Acta Otolaryngol 134:636–645
Ojesina AI, Lichtenstein L, Freeman SS, Pedamallu CS, Imaz-Rosshandler I et al (2014) Landscape of genomic alterations in cervical carcinomas. Nature 506:371–375
Osthus AA, Aarstad AK, Olofsson J, Aarstad HJ (2013) Prediction of survival by pretreatment health-related quality-of-life scores in a prospective cohort of patients with head and neck squamous cell carcinoma. JAMA Otolaryngol Head Neck Surg 139:14–20
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376
Piccirillo JF, Tierney RM, Costas I, Grove L, Spitznagel EL Jr (2004) Prognostic importance of comorbidity in a hospital-based cancer registry. JAMA 291:2441–2447
Aarstad HJ, Vintermyr OK, Ulvestad E, Aarstad HH, Kross KW et al (2015) Peripheral blood monocyte and T-lymphocyte activation levels at diagnosis predict long-term survival in head and neck squamous cell carcinoma patients. APMIS 123:305–314
Osthus AA, Aarstad AK, Olofsson J, Aarstad HJ (2011) Head and neck specific health related quality of life scores predict subsequent survival in successfully treated head and neck cancer patients: a prospective cohort study. Oral Oncol 47:974–979
Osthus AA, Aarstad AK, Olofsson J, Aarstad HJ (2011) Health-related quality of life scores in long-term head and neck cancer survivors predict subsequent survival: a prospective cohort study. Clin Otolaryngol 36:361–368
Urba S, Gatz J, Shen W, Hossain A, Winfree K et al (2012) Quality of life scores as prognostic factors of overall survival in advanced head and neck cancer: analysis of a phase III randomized trial of pemetrexed plus cisplatin versus cisplatin monotherapy. Oral Oncol 48:723–729
Tarsitano A, Pizzigallo A, Ballone E, Marchetti C (2012) Health-related quality of life as a survival predictor for patients with oral cancer: is quality of life associated with long-term overall survival? Oral Surg Oral Med Oral Pathol Oral Radiol 114:756–763
Tsai WL, Chien CY, Huang HY, Liao KC, Fang FM (2013) Prognostic value of quality of life measured after treatment on subsequent survival in patients with nasopharyngeal carcinoma. Qual Life Res 22:715–723
Truong MT, Zhang Q, Rosenthal DI, List M, Axelrod R et al. (2016) Quality of life and performance status from a substudy conducted within a prospective phase 3 randomized trial of concurrent accelerated radiation plus cisplatin with or without cetuximab for locally advanced head and neck carcinoma: NRG Oncology Radiation Therapy Oncology Group 0522. Int J Radiat Oncol Biol Phys
Yang CJ, Roh JL, Kim MJ, Lee SW, Kim SB et al (2016) Pretreatment quality of life as a prognostic factor for early survival and functional outcomes in patients with head and neck cancer. Qual Life Res 25:165–174
Beisland E, Aarstad AK, Osthus AA, Aarstad HJ (2013) Stability of distress and health-related quality of life as well as relation to neuroticism, coping and TNM stage in head and neck cancer patients during follow-up. Acta Otolaryngol 133:209–217
Quinten C, Martinelli F, Coens C, Sprangers MA, Ringash J et al (2014) A global analysis of multitrial data investigating quality of life and symptoms as prognostic factors for survival in different tumor sites. Cancer 120:302–311
Zikos E, Coens C, Quinten C, Ediebah DE, Martinelli F et al. (2016) The added value of analyzing pooled health-related quality of life data: a review of the EORTC PROBE initiative. J Natl Cancer Inst 108
Lechner M, Fenton TR (2016) The genomics, epigenomics, and transcriptomics of hpv-associated oropharyngeal cancer–understanding the basis of a rapidly evolving disease. Adv Genet 93:1–56
Grignon LM, Jameson MJ, Karnell LH, Christensen AJ, Funk GF (2007) General health measures and long-term survival in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 133:471–476
Osthus AA, Aarstad AK, Olofsson J, Aarstad HJ (2013) Comorbidity is an independent predictor of health-related quality of life in a longitudinal cohort of head and neck cancer patients. Eur Arch Otorhinolaryngol 270:1721–1728
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This work has been supported by the Norwegian Cancer Society.
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This article does not contain any studies with animals performed by the authors. The study was conducted in accordance with the guidelines of the Declaration of Helsinki and its subsequent amendments and was approved by the institutional review board according to national regulations.
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Aarstad, H.J., Østhus, A.A., Aarstad, H.H. et al. General health-related quality of life scores from head and neck squamous cell carcinoma patients obtained throughout the first year following diagnosis predicted up to 10-year overall survival. Eur Arch Otorhinolaryngol 275, 207–217 (2018). https://doi.org/10.1007/s00405-017-4800-8
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DOI: https://doi.org/10.1007/s00405-017-4800-8