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Predictors of health-related quality of life in patients treated with neck dissection for head and neck cancer

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Abstract

Patients with head and neck cancer can report reduced health-related quality of life several years after treatment. The aim of this study was to identify risk factors for reduced quality of life in patients up to 5 years following neck dissection. This cross-sectional study was conducted at two hospitals in Brisbane, Australia. Patients completed two measures of quality of life: the Neck Dissection Impairment Index (NDII), a region- and disease-specific tool, and the Assessment of Quality of Life-4 Domains, a general tool. Generalised linear modelling was used to determine which demographic and clinical variables were associated with quality of life. The cohort included n = 129 patients (71% male, median age 61, median 3 years since surgery). Positive nodal disease was associated with better quality of life on the NDII [e.g. N2 vs N0 coeff (95% CI) = 22.84 (7.33, 38.37)]. Worse quality of life was associated with adjuvant treatment [e.g. Independent Living domain model: surgery with chemoradiation vs surgery only coeff (95% CI) = −0.11 (−0.22, −0.01)]. Positive nodal disease was associated with better quality of life, which may be a reflection of response shift. Multimodality treatment leads to worse quality of life compared with surgery only.

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Acknowledgements

The authors wish to thank research assistant Annette Stouter for her contribution to this study (data entry and data management); and the Medical, Nursing, Physiotherapy and Administrative staff from the participating hospitals.

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Authors and Affiliations

  1. School of Health and Rehabilitation Sciences, The University of Queensland, Building 84A, St Lucia, QLD, 4072, Australia

    Elise M. Gane, Anna L. Hatton & Shaun P. O’Leary

  2. Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Australia

    Elise M. Gane & Steven M. McPhail

  3. School of Public Health and Social Work and the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia

    Steven M. McPhail

  4. Otolaryngology-Head and Neck Surgery Department, Princess Alexandra Hospital, Brisbane, Australia

    Benedict J. Panizza

  5. Faculty of Medicine, The University of Queensland, Brisbane, Australia

    Benedict J. Panizza

  6. Physiotherapy Department, Royal Brisbane and Women’s Hospital, Brisbane, Australia

    Shaun P. O’Leary

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  1. Elise M. Gane
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Correspondence to Elise M. Gane.

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The authors declared no conflicts of interest with respect to the research, authorship, and/or publication of this manuscript.

Funding

This research was supported by a 2015 Seeding Grant (S15-029) from the Physiotherapy Research Foundation, Australia. Elise Gane is supported by an Australian Government Research Training Program Scholarship. Assoc Prof Steven McPhail is supported by a National Health and Medical Research Council (of Australia) Fellowship [#1090440]. No provider of funding had any influence over any part of the study or manuscript.

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“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

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Gane, E.M., McPhail, S.M., Hatton, A.L. et al. Predictors of health-related quality of life in patients treated with neck dissection for head and neck cancer. Eur Arch Otorhinolaryngol 274, 4183–4193 (2017). https://doi.org/10.1007/s00405-017-4754-x

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