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Farlow JL, McCrary HC, Sipos JA, Phay JE, Konda B, Agrawal A. Neoadjuvant dabrafenib and trametinib for functional organ preservation in recurrent BRAF V600E-mutated papillary thyroid cancer. Oral Oncol 2023; 147:106625. [PMID: 37948895 DOI: 10.1016/j.oraloncology.2023.106625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES To describe the first reported use of neoadjuvant dabrafenib and trametinib specifically to permit organ conservation surgery in locally advanced recurrent differentiated thyroid carcinoma. PATIENTS AND METHODS A patient presented with locally recurrent, radioiodide-resistant DTC with a BRAF V600E mutation invading the laryngotrachea. Definitive treatment would require a total laryngectomy. She was offered neoadjuvant dabrafenib and trametinib prior to surgery. RESULTS A significant radiographic response permitted partial laryngectomy, enabling preservation of voice, early resumption of oral feeding, and avoidance of permanent tracheostomy. At 9 months, she remained free of disease. CONCLUSION Neoadjuvant tyrosine kinase inhibitor treatment prior to definitive surgery for locally-invasive recurrent DTC is a potential approach that may limit the degree of surgery and associated morbidity.
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Affiliation(s)
- Janice L Farlow
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, IN, USA
| | - Hilary C McCrary
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA
| | - Jennifer A Sipos
- Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - John E Phay
- Division of Surgical Oncology, Department of Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Bhavana Konda
- Division of Medical Oncology, Department of Internal Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Amit Agrawal
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Weidlich S, Pfeiffer J, Kugler C. Self-management of patients with tracheostomy in the home setting: a scoping review. J Patient Rep Outcomes 2023; 7:101. [PMID: 37823948 PMCID: PMC10570259 DOI: 10.1186/s41687-023-00643-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023] Open
Abstract
PURPOSE The aim of this study was to create a model of patient-centered outcomes with respect to self-management tasks and skills of patients with a tracheostomy in their home setting. METHODS A scoping review using four search engines was undertaken (Medline, CINAHL, PsycINFO, Cochrane Library) to identify studies relevant to this issue and published since 2000. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statements for Scoping Reviews (PRISMA-ScR), the Joanna Briggs Institute (JBI) approach of conducting and reporting a scoping review, and the Participants, Concept, Context (PCC) scheme were employed. The following elements of the framework synthesis study data were screened, and presented based on the self-management model of Lorig and Holman. RESULTS 34 publications from 17 countries met the criteria for study inclusion: 24 quantitative, 8 qualitative and 2 mixed methods designs. Regarding the dimensions of self-management, 28 articles reported on "managing the therapeutic regimen", 27 articles discussed "managing role and behavior changes", and 16 articles explored "managing emotions". A model of self-management of patients with tracheostomy was developed, which placed the patient in the center, since it is this individual who is completing the tasks and carrying out his or her skill sets. CONCLUSION This scoping review represents the first comprehensive overview and modeling of the complex self-management tasks and skills required of patients with tracheostomy in their home setting. The theoretical model can serve as a cornerstone for empirical intervention studies to better support this patient-centered outcome for this population in the future.
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Affiliation(s)
- Sandra Weidlich
- Faculty of Medicine, Department of Oto-Rhino-Laryngology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Jens Pfeiffer
- Center for Oto-Rhino-Laryngology (HNO Center am Theater), Freiburg, Germany
| | - Christiane Kugler
- Faculty of Medicine, Institute of Nursing Science, University of Freiburg, Breisacher Str. 153, Freiburg, 79110, Germany.
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Fritz C, Rajasekaran K. Delayed in diagnosis of upper aerodigestive tract cancers: A comprehensive review of medical malpractice cases. Head Neck 2023. [PMID: 37144329 DOI: 10.1002/hed.27390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/28/2023] [Accepted: 04/25/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Factors that prompt litigation and influence outcomes for malpractice cases involving cancers of the upper aerodigestive tract are incompletely described. METHODS Westlaw, a national legal database, was searched for medical malpractice claims related to upper aerodigestive tract cancer for all years available. RESULTS Of the 122 cases meeting inclusion criteria, 106 (86.9%) involved allegations of failure to diagnose or delay in diagnosis. Tongue, larynx, and nasopharynx cancers were more frequently litigated than would be expected based on their incidence (tongue, 38.7% of aerodigestive tract litigation vs. 26.9% of aerodigestive tract cancers; larynx, 33.0% vs. 22.3%; nasopharynx, 10.4% vs. 4.6%). Payouts were made in over half of diagnosis failure lawsuits (56.6%), which carried an average award of $2840690 [IQR 850219-2537509]. CONCLUSIONS An awareness of litigation on cancers of the upper aerodigestive tract holds the potential to improve patient care and help otolaryngologists avoid potential risks for litigation.
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Affiliation(s)
- Christian Fritz
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Yang X, Ge S, Tao Y, Li J, Shang W, Song K. Assessment of the observation management of sialocele after partial superficial parotidectomy. Oral Dis 2023; 29:996-1004. [PMID: 34773330 DOI: 10.1111/odi.14079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/05/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to investigate the usefulness of management of sialocele formation and to evaluate the quality of life of patients under elective management post-parotidectomy. MATERIALS AND METHODS A prospective study was performed including patients who underwent postoperative management with either compression therapy or observation. The self-filled questionnaire method was used to assess the quality of life of participants who changed from compression therapy to observation. Demographic and operative data, variables regarding wound complications and scores for quality of life were documented and analysed. RESULTS A total of 86 patients met the eligibility criteria. The respective rates of sialocele formation within 1 month were 5.3% in the compression therapy group (2/38) and 16.0% in the observation group (4/25), but no significant difference was observed (p = 0.204). Meanwhile, both groups displayed comparable times of needle aspiration and time for sialocele resolution (p > 0.05). Based on 23 valid paired questionnaires, scores for physical and social-emotional function before changing from compression therapy to observation were significantly lower than scores after the change (p < 0.001). CONCLUSION The application of observation after partial superficial parotidectomy appears to have acceptable clinical outcomes and considerable improvements in quality of life.
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Affiliation(s)
- Xiaochen Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
- School of Stomatology, Qingdao University, Shandong, China
| | - Shengyou Ge
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
- School of Stomatology, Qingdao University, Shandong, China
| | - Yueqin Tao
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
| | - Jieying Li
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
- School of Stomatology, Qingdao University, Shandong, China
| | - Wei Shang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
- School of Stomatology, Qingdao University, Shandong, China
| | - Kai Song
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Shandong, China
- School of Stomatology, Qingdao University, Shandong, China
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Moffatt DC, Lahaye JJ, Corona KK, Rossi NA, Joshi R, Resto V, McKinnon BJ, Coblens OM. Laryngectomy: Social media analysis of patient perception. Head Neck 2023; 45:464-472. [PMID: 36515649 DOI: 10.1002/hed.27261] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/12/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Social media continues to grow as a relevant information source for the lay public and medical professionals. METHODS A search of posts on Facebook and Instagram was conducted using the hashtag #laryngectomy. Posts were categorized based upon perspective, media type, timeframe, topic, tone, and popularity. RESULTS Final analysis included 929 Instagram posts and 355 Facebook posts. Most Facebook posts were made by companies (38%) and physicians (17%) with information (30%) and advertisements (22%) being common topics. Patients (40%) were the largest group of Instagram authors with lifestyle (39%) being the most common topic. Greater than 90% of posts were either neutral or positive in tone across both platforms. CONCLUSIONS Patient perspective was most commonly represented on Instagram, whereas Facebook more commonly included posts by physicians and companies. The majority of posts carried a neutral or positive tone, which is consistent with positive quality of life patients have shown postoperatively.
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Affiliation(s)
- David C Moffatt
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, United States
| | - Joshua J Lahaye
- School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Kassandra K Corona
- School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Nicholas A Rossi
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Rohan Joshi
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Vicente Resto
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Brian J McKinnon
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Orly M Coblens
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, Texas, USA
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Haring CT, Farlow JL, Leginza M, Vance K, Blakely A, Lyden T, Hoesli RC, Neal MEH, Brenner MJ, Hogikyan ND, Morrison RJ, Casper KA. Effect of Augmentative Technology on Communication and Quality of Life After Tracheostomy or Total Laryngectomy. Otolaryngol Head Neck Surg 2022; 167:985-990. [PMID: 34060949 DOI: 10.1177/01945998211013778] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Surgical procedures that render patients acutely aphonic can cause them to experience significant anxiety and distress. We queried patient perceptions after tracheostomy or laryngectomy and investigated whether introducing augmentative technology was associated with improvement in patient-reported outcomes. METHODS Participants included hospitalized patients who acutely lost the ability to speak due to tracheostomy or total laryngectomy from April 2018 to December 2019. We distributed questions regarding the patient communication experience and relevant questions from the validated V-RQOL questionnaire (Voice-Related Quality of Life). Patients were offered a tablet with the electronic communication application Verbally. Pre- and postintervention groups were compared with chi-square analyses. RESULTS Surveys were completed by 35 patients (n = 18, preintervention; n = 17, postintervention). Prior to using augmentative technology, 89% of patients who were aphonic reported difficulty communicating, specifically noting breathing or suctioning (56%), treatment and discharge plans (78%), or immediate needs, such as pain and using the bathroom (39%). Communication difficulties caused anxiety (55%), depression (44%), or frustration (62%), and 92% of patients were interested in using an electronic communication device. Patients reported less trouble communicating after the intervention versus before (53% vs 89%, P = .03), including less difficulty communicating about treatment or discharge plans (35% vs 78%, P < .01). V-RQOL scores were unchanged. DISCUSSION Acute loss of phonation arising from surgery can be highly distressing for patients, and use of augmentative technology may alleviate some of these challenges by improving communication. Further studies are needed to identify what additional strategies may improve overall well-being. IMPLICATIONS FOR PRACTICE Electronic communication devices may benefit patients with acute aphonia.
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Affiliation(s)
- Catherine T Haring
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Janice L Farlow
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Marie Leginza
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Kaitlin Vance
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Anna Blakely
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Teresa Lyden
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Molly E Heft Neal
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael J Brenner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Norman D Hogikyan
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Robert J Morrison
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Keith A Casper
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
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St Peter M, Ward C, Nancy N, Sykes KJ. Quality of Life in Caregivers, Spouses, and Partners of Total Laryngectomees: A Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1426-1434. [PMID: 35245083 DOI: 10.1044/2021_jslhr-21-00404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to (a) review methods used to assess quality of life (QOL) in caregivers, partners, and spouses of those who have undergone total laryngectomy (TL); (b) identify patterns in caregiver QOL changes postoperatively; and (c) review previously proposed interventions for caregivers. METHOD PubMed, EMBASE, and CINAHL Complete were searched using the Medical Subject Heading terms laryngectomy, spouse, caregiver, and partner. Two reviewers independently screened and identified records meeting inclusion criteria. This scoping review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Initial search returned 143 results and 12 met inclusion criteria. Eight studies assessed postoperative QOL changes in categories such as psychological health, physical health, sexuality, and interpersonal relationships. Four studies proposed interventions for caregivers perioperatively. There were no consistently used inventories, and only one intervention was formally tested. CONCLUSIONS The literature available on TL caregiver QOL contains inconsistent inventories and study design. There are few interventions available, and it would be beneficial to develop a standardized QOL inventory for this population to better target caregiver needs. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19287887.
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Affiliation(s)
- Madeleine St Peter
- Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City
- University of Kansas School of Medicine, Kansas City
| | - Christina Ward
- Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City
- University of Kansas School of Medicine, Kansas City
| | - Naomi Nancy
- Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City
| | - Kevin J Sykes
- Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City
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Hong SW, Chan RW. Acoustic Analysis of Taiwanese Tones in Esophageal Speech and Pneumatic Artificial Laryngeal Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1215-1227. [PMID: 35226568 DOI: 10.1044/2021_jslhr-21-00380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE This study examined the acoustic properties of Taiwanese (Southern Min) lexical tones produced in esophageal speech (ES) and pneumatic artificial laryngeal speech (PAL), including onset fundamental frequency (F0), slope of F0 contour, duration, and amplitude (intensity) of the vowel portion of syllables carrying seven Taiwanese tones. METHOD Seven ES speakers, seven PAL speakers, and 18 normal laryngeal (NL) speakers (all male) read aloud target syllables carrying the tones in monosyllables, disyllables, and sentences. Acoustic features were measured with Praat. RESULTS Acoustic analysis revealed (a) no significant effects of linguistic level on acoustic parameters except for duration, which generally significantly decreased from monosyllables to disyllables to sentences for Tones 1 and 5; (b) significant differences across the speaker groups in onset F0 (PAL > ES > NL), duration (PAL > NL and PAL > ES for all tones), and mean amplitude (PAL > NL > ES); and (c) no significant difference in mean slope of F0 contour across the speaker groups. CONCLUSIONS These preliminary data on acoustic properties of Taiwanese tones produced by ES and PAL speakers could facilitate the design of therapeutic strategies for improving the intelligibility of alaryngeal lexical tones. Further studies are recommended to examine the relative perceptual importance of the acoustic parameters.
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Affiliation(s)
- Szu-Wei Hong
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taiwan
| | - Roger W Chan
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taiwan
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MacDonald C, Theurer JA, Fung K, Yoo J, Doyle PC. Resilience: an essential element in head and neck cancer survivorship and quality of life. Support Care Cancer 2021; 29:3725-3733. [PMID: 33201311 DOI: 10.1007/s00520-020-05873-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 11/02/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE Individuals with head and neck cancer (HNCa) face myriad biopsychosocial challenges. Even after treatment completion, these challenges may cause continued disablement and diminished quality of life (QoL). Resilience may serve to minimize the disabling impact of HNCa and, in turn, maximize QoL. The purpose of this study was to formally assess resilience in HNCa survivors and explore its relationship with QoL. METHODS A cross-sectional descriptive study was conducted. Forty HNCa survivors completed three validated, self-report questionnaires pertaining to the collection of resilience and QoL data. Descriptive and correlational analyses were performed. RESULTS Resilience was identified in HNCa survivors and a positive correlation was found between resilience and QoL. CONCLUSIONS Data suggest that resilience may buffer the influence of HNCa on QoL. Thus, screening for reduced levels of resilience may proactively facilitate identification of those who are most vulnerable to the psychosocial impact of HNCa. Interventions that foster resilience may ameliorate the challenges of HNCa and maximize QoL.
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Affiliation(s)
- Chelsea MacDonald
- Laboratory for Well-Being and Quality of Life in Oncology, Rehabilitation Sciences, Western University, Elborn College, Room 2200, 1201 Western Rd., London, N6G 1H1, Canada.
| | - Julie A Theurer
- School of Communication Sciences and Disorders, Western University, London, ON, Canada
- Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine & Dentistry, London, Canada
| | - Kevin Fung
- Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine & Dentistry, London, Canada
| | - John Yoo
- Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine & Dentistry, London, Canada
| | - Philip C Doyle
- Laboratory for Well-Being and Quality of Life in Oncology, Rehabilitation Sciences, Western University, Elborn College, Room 2200, 1201 Western Rd., London, N6G 1H1, Canada
- Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine & Dentistry, London, Canada
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Trends in, and predictors of, swallowing and social eating outcomes in head and neck cancer survivors: A longitudinal analysis of head and neck 5000. Oral Oncol 2021; 118:105344. [PMID: 34023744 DOI: 10.1016/j.oraloncology.2021.105344] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/04/2021] [Accepted: 05/08/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the recovery trajectory and predictors of outcome for swallowing difficulties following head and neck cancer treatment in a large prospective cohort. MATERIALS AND METHODS Data from 5404 participants of the Head and Neck 5000 study were collected from 2011 to 2014. Patient-reported swallowing was measured using the EORTC HN35, recorded at baseline (pre-treatment) and 4 and 12 months post-baseline. Mixed-effects linear multivariable regression was used to investigate time trends, compare cancer sites, and identify associations between clinical, socio-demographic and lifestyle variables. RESULTS 2458 participants with non-recurrent oral (29%) oropharyngeal (46%) and laryngeal (25%) cancer were included in the analysis. There was a clinically significant deterioration in scores between baseline and four months for swallowing (11.7 points; 95% CI 10.7-12.8) and trouble with social eating (17.9 points; 95% CI 16.7-19.2), but minimal difference between baseline and 12 months. Predictors of better swallowing and social eating were participants with larynx cancer, early-stage disease, treatment type, age, gender, co-morbidity, socio-economic status, smoking behaviour and cohabitation. CONCLUSION Swallowing problems persist up to a year after head and neck cancer treatment. These findings identify disease and demographic characteristics for particularly vulnerable groups, supporting the need for holistic interventions to help improve swallowing outcomes. People diagnosed with head and neck cancer at risk of severe eating and drinking problems following treatment can be identified earlier in the pathway, receive more accurate information about early and late post-treatment side-effects, which can inform shared decision-making discussions.
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Rühle A, Haehl E, Kalckreuth T, Stoian R, Spohn SKB, Sprave T, Zamboglou C, Gkika E, Knopf A, Grosu AL, Nicolay NH. Surviving Elderly Patients with Head-and-Neck Squamous Cell Carcinoma-What Is the Long-Term Quality of Life after Curative Radiotherapy? Cancers (Basel) 2021; 13:cancers13061275. [PMID: 33805662 PMCID: PMC7999122 DOI: 10.3390/cancers13061275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 01/05/2023] Open
Abstract
The effects of radiotherapy on the long-term quality of life (QoL) of surviving elderly HNSCC patients are not well understood, therefore, we analyzed QoL in this population. A cross-sectional analysis was performed at a tertiary cancer center to assess long-term QoL in elderly HNSCC patients. Eligible patients were ≥65 years at the time of treatment who had to be alive for ≥1 year after radiotherapy and without current anti-cancer treatment. QoL and patient satisfaction were assessed using the EORTC QLQ-C30, QLQ-H&N35 and ZUF-8 questionnaires, respectively, and treatment-related toxicities were graded according to CTCAE (Common Terminology Criteria of Adverse Effects) v.5.0. Seventy-four patients met the inclusion criteria, of which 50 consented to participate. Median time between radiotherapy and QoL assessment was 32 months (range 12-113). The QLQ-C30 global QoL median amounted to 66.7 points (interquartile range (IQR) 50.0-83.3), which was comparable to the age- and gender-adjusted German population (median 65.3). Median global QoL was similar between patients undergoing definitive (75.0, IQR 50.0-83.3) and adjuvant (chemo)radiotherapy (66.7, IQR 41.7-83.3, p = 0.219). HPV-positive HNSCC patients had superior global QoL after radiotherapy than their HPV-negative counterparts (p < 0.05), and concomitant chemotherapy did not influence the long-term QoL (p = 0.966). Median global QoL did not correspond with physician-assessed highest-graded chronic toxicities (p = 0.640). The ZUF-8 ranged at 29 points in median (IQR 27-31), showing high patient satisfaction. Surviving elderly HNSCC patients treated by radiotherapy exhibit a relatively high long-term global QoL which is a relevant information for clinicians treating elderly HNSCC patients.
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Affiliation(s)
- Alexander Rühle
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Erik Haehl
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Tobias Kalckreuth
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Raluca Stoian
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Simon K. B. Spohn
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Tanja Sprave
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Constantinos Zamboglou
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Eleni Gkika
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Andreas Knopf
- Department of Otorhinolaryngology, University of Freiburg—University Medical Center Freiburg, Killianstr. 5, 79106 Freiburg, Germany;
| | - Anca-Ligia Grosu
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Nils H. Nicolay
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-761-270-94010
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12
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Wulff NB, Højager A, Wessel I, Dalton SO, Homøe P. Health-Related Quality of Life Following Total Laryngectomy: A Systematic Review. Laryngoscope 2020; 131:820-831. [PMID: 32866284 DOI: 10.1002/lary.29027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/13/2020] [Accepted: 07/25/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Treatment of advanced laryngeal and hypopharyngeal cancer has shifted from total laryngectomy (TL) toward laryngeal-preserving therapies due to a general perception that TL has a significantly negative impact on the individual's life. However, whether the physical impairments related to TL translate to a reduced health-related quality of life (HRQoL) has not yet been determined. Therefore, the objective of this systematic review was to determine how HRQoL is affected following TL. METHODS Systematic searches were conducted in PubMed, Embase, and Cochrane. Inclusion criteria were original studies describing quality of life following TL after larynx/hypopharynx cancer using a formally developed patient-reported questionnaire. Study quality assessment was carried out with the tool developed by the National Heart, Lung, and Blood Institute. RESULTS Forty-six studies using 12 different questionnaires were included. The majority were cross-sectional (85%), and study quality was rated poor in 30%, fair in 30%, and good in 39% of studies. When comparing results from the four most frequently used questionnaires with normative data, we found that in more than 60% of studies, differences to the reference population were of clinical importance, with only few exceptions. CONCLUSIONS In general, we found that people who received TL have a worse HRQoL than the male normative reference population. However, even though TL patients experience a clinically important difference in many domains when compared with normative data, their burden of symptoms is generally mild. The current review also makes it evident that despite the relatively large number of studies conducted, the strength of evidence remains weak. Laryngoscope, 131:820-831, 2021.
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Affiliation(s)
- Nille B Wulff
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - Anna Højager
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Susanne O Dalton
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Naestved, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Kemps GJF, Krebbers I, Pilz W, Vanbelle S, Baijens LWJ. Affective symptoms and swallow-specific quality of life in total laryngectomy patients. Head Neck 2020; 42:3179-3187. [PMID: 32621568 PMCID: PMC7586820 DOI: 10.1002/hed.26365] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 05/26/2020] [Accepted: 06/16/2020] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study is to determine the prevalence of clinically relevant affective symptoms and level of swallow‐specific quality of life (QoL) in dysphagic patients with total laryngectomy (TL) and to explore the relationship between affective symptoms and swallow‐specific QoL. Methods Thirty‐five TL patients completed the Hospital Anxiety and Depression Scale (HADS) and the MD Anderson Dysphagia Inventory (MDADI). Student's t test and linear regression were used. Results Eight (23%) patients showed clinically relevant symptoms of anxiety, 8 (23%) of depression, and 11 (31%) showed either one. These groups had significantly lower mean MDADI scores. One‐point increase in HADS‐anxiety or HADS‐depression subscale score corresponds with a decrease of 2.7 or 3.0 points, on average, respectively, of the MDADI total score. Conclusions Clinically relevant affective symptoms were present in approximately one‐third of the TL patients. These preliminary results show that increased affective symptom scores correlate with a decreased swallow‐specific QoL.
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Affiliation(s)
- Glen J F Kemps
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
| | - Iris Krebbers
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
| | - Walmari Pilz
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,School of Mental Health and Neurosciences (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Sophie Vanbelle
- Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands.,Care and Public Health Research Institute - CAPHRI, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Laura W J Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
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14
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Antin F, Breheret R, Goineau A, Capitain O, Laccourreye L. Rehabilitation following total laryngectomy: Oncologic, functional, socio-occupational and psychological aspects. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:19-22. [PMID: 32586777 DOI: 10.1016/j.anorl.2020.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
GOAL To review rehabilitation following total laryngectomy by an analysis of epidemiological, oncologic and functional data. MATERIALS AND METHODS This retrospective observational study focused on patients having undergone total laryngectomy or pharyngolaryngectomy between January 1, 2005 and December 31, 2016. Oncologic data notably comprised survival and relapse and predictive factors. The impact of the procedure on quality of life and the voice was analyzed by self-administered questionnaires (EORTC QLQ-C30 and H&N35, VHI 30). A satisfaction questionnaire was also sent to patients. RESULTS One hundred and thirty three patients were included. Overall specific 5-year survival was 65%. The relapse rate was 32%. Factors influencing survival were WHO performance status ≥2 (P<0.05), tumor location (P=0.07), metastatic lymphadenopathy (P=0.017) and positive resection margins (P=0.01). Quality of life was moderately degraded (global EORTC QLQ-C30 status: 61.4±23.9). Type of rehabilitation (P=0.03), tube feeding (P=0.03) and relapse (P<0.01) influenced quality of life. There were no differences in voice quality according to rehabilitation method, and no predictive factors for failure of voice rehabilitation. More than 90% of patients were satisfied with their hospital stay; 43%, however, were not satisfied with community caregiver training for laryngectomy patients. CONCLUSION Rehabilitation of laryngectomized patients is a current therapeutic challenge. A therapeutic education tool was designed to better meet patient expectations.
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Affiliation(s)
- F Antin
- Service ORL et CCF, CHU Angers, 4, rue Larrey, 49100 Angers, France.
| | - R Breheret
- Service ORL et CCF, CHU Angers, 4, rue Larrey, 49100 Angers, France
| | - A Goineau
- Service d'oncologie médicale et Radiothérapie, CO - Site Paul Papin, 15, rue André-Bocquel, 49100 Angers, France
| | - O Capitain
- Service d'oncologie médicale et Radiothérapie, CO - Site Paul Papin, 15, rue André-Bocquel, 49100 Angers, France
| | - L Laccourreye
- Service ORL et CCF, CHU Angers, 4, rue Larrey, 49100 Angers, France
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15
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Mady LJ, Lyu L, Owoc MS, Peddada SD, Thomas TH, Sabik LM, Johnson JT, Nilsen ML. Understanding financial toxicity in head and neck cancer survivors. Oral Oncol 2019; 95:187-193. [PMID: 31345389 DOI: 10.1016/j.oraloncology.2019.06.023] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 06/21/2019] [Accepted: 06/22/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES (1) Describe financial toxicity (FT) in head and neck cancer (HNC) survivors and assess its association with personal/health characteristics and health-related quality of life (HRQOL); (2) examine financial coping mechanisms (savings/loans); (3) assess relationship between COmprehensive Score for financial Toxicity (COST) and Financial Distress Questionnaire (FDQ). PATIENTS AND METHODS Cross-sectional survey from January - April 2018 of insured patients at a tertiary multidisciplinary HNC survivorship clinic who completed primary treatment for squamous cell carcinoma of the oral cavity, oropharynx, or larynx/hypopharynx. RESULTS Of 104 survivors, 30 (40.5%) demonstrated high FT. Patients with worse FT were more likely (1) not married (COST, 25.33 ± 1.87 vs. 30.61 ± 1.34, p = 0.008); (2) of lower education levels (COST, 26.12 ± 1.47 vs. 34.14 ± 1.47, p < 0.001); and (3) with larynx/hypopharynx primaries (COST, 22.86 ± 2.28 vs. 30.27 ± 1.50 vs. 32.72 ± 1.98, p = 0.005). Younger age (4.23, 95%CI 2.20 to 6.26, p < 0.001), lower earnings at diagnosis (1.17, 95%CI 0.76 to 1.58, p < 0.001), and loss in earnings (-1.80, 95%CI -2.43 to -1.16, p < 0.001) were associated with worse FT. COST was associated with HRQOL (0.08, p = 0.03). Most survivors (63/102, 60%) reported using savings and/or loans. Worse FT was associated with increased likelihood of using more mechanisms (COST, OR1.06, 95%CI 1.02 to 1.10, p = 0.004). Similar results were found with FDQ. CONCLUSIONS We found differences in FT by primary site, with worst FT in larynx/hypopharynx patients. This finding illuminates potential site-specific factors, e.g. workplace discrimination or inability to return to work, that may contribute to increased risk. FDQ correlates strongly with COST, encouraging further exploration as a clinically-meaningful screening tool.
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Affiliation(s)
- Leila J Mady
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | - Lingyun Lyu
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Maryanna S Owoc
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Shyamal D Peddada
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Teresa H Thomas
- Department of Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, PA, United States
| | - Lindsay M Sabik
- Department of Health Policy and Management, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Jonas T Johnson
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Marci L Nilsen
- Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA, United States
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16
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Kotake K, Kai I, Iwanaga K, Suzukamo Y, Takahashi A. Effects of occupational status on social adjustment after laryngectomy in patients with laryngeal and hypopharyngeal cancer. Eur Arch Otorhinolaryngol 2019; 276:1439-1446. [PMID: 30927102 PMCID: PMC6458974 DOI: 10.1007/s00405-019-05378-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 03/11/2019] [Indexed: 11/25/2022]
Abstract
Purpose This study was performed to examine the relationship of social adjustment with occupation and life changes in patients with laryngeal and hypopharyngeal cancer, from before laryngectomy to 1 year after hospital discharge. Methods The subjects were 27 patients with laryngeal and hypopharyngeal cancer who were admitted to hospital for laryngectomy and provided informed consent for participation in the study. The patients answered questionnaire surveys before surgery, and 3, 6, and 12 months after hospital discharge. Regarding social adjustment, social functioning (SF) and mental health (MH) in SF-36V2 were used as dependent variables, and time, occupation status, age, family structure, and sex as independent variables. Repeated measures analysis of variance was used to examine the main effect, and second- and third-order interactions were also examined. Results The age of the subjects was 62.9 ± 6.4 years and about 30% had an occupation. Loss of voice was the reason for 30% leaving work. In an examination of the main effects of the four variables, only age was significant regarding SF, and SF was favorable in subjects aged ≥ 64 years old. Regarding MH, age and family structure were significant, and MH was higher in older subjects who lived alone. The interaction between time and the other 3 variables was not significant. Only time/age/occupation was significant for MH. Regarding SF, a weak interaction was suggested, but it was not significant. Conclusion Older subjects showed better social adjustment, and those who lived alone had better MH. These findings may have been due to a reduced environmental influence. MH of subjects with an occupation decreased more at 3 months or later after hospital discharge, compared to those without an occupation. Especially for younger patients, development of new approaches is required to allow families and colleagues of patients to understand the difficulties of patients with laryngeal and hypopharyngeal cancer.
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Affiliation(s)
- Kumiko Kotake
- Faculty of Nursing, Nara Medical University, 840 Shijou-cho, Kashihara, Nara, Japan.
| | - Ichiro Kai
- Graduate School of Medicine, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Kazuyo Iwanaga
- School of Nursing, Faculty of Medicine, Fukuoka University, 8-19-1, Nanakuma, Jonan-ku, Fukuoka, Fukuoka, Japan
| | - Yoshimi Suzukamo
- Physical Medicine and Rehabilitation, Tohoku University School of Medicine, 2-1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan
| | - Aya Takahashi
- Department of Nursing, Saitama Prefectural University, 820, Sannomiya, Koshigaya, Saitama, Japan
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Kosaka M, Sumita YI, Taniguchi H, Suzuki T, Sasaki K. Evaluation of salivary cortisol levels in relation to dento-maxillary prosthesis adjustment. J Prosthodont Res 2019; 63:73-77. [PMID: 30266664 DOI: 10.1016/j.jpor.2018.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 08/12/2018] [Accepted: 08/15/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The purpose of this study was to investigate the influence of dento-maxillary prosthesis adjustment procedure on levels of salivary cortisol. METHODS Nine participants (six men, three women, mean age 65.9 years) took part in this study. Saliva samples were collected before and after dento-maxillary prosthesis adjustment during the four different visits. Free cortisol levels were determined using a salivary cortisol immunoassay kit (expanded-range high-sensitivity salivary cortisol enzyme immunoassay kit, Salimetrics). Besides, original self-report sheets, a 35-item food intake questionnaire, the University of Washington Quality of Life (UW-QOL) questionnaire version 4, and the Geriatric Oral Health Assessment Index (GOHAI) questionnaire were also administered. The changes of salivary cortisol levels were analyzed using 2-level multilevel linear regression, with adjustment for age, sex, and time. Wilcoxon signed-rank test was used to compare scores of the food intake questionnaire, UW-QOL questionnaire, and GOHAI questionnaire. RESULTS Salivary cortisol levels decreased significantly after carrying out the dento-maxillary prosthesis adjustment procedure. During the third adjustment, the salivary cortisol levels were significantly low. In addition, salivary cortisol levels of participants aged 70 years and over were significantly higher than other aged groups. The total scores for grade III-V of the food intake questionnaire increased significantly. Other questionnaires had a trend toward increasing scores, yet the differences were not significant. CONCLUSIONS Within the limitations of this study, the results suggest that a reduction in symptoms of discomfort may have an influence on the decrease of salivary cortisol levels in dento-maxillary prosthesis wearers.
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Affiliation(s)
- Moe Kosaka
- Division of Dental and Digital Forensics, Tohoku University Graduate School of Dentistry, Sendai, Japan; Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuka I Sumita
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hisashi Taniguchi
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Toshihiko Suzuki
- Division of Dental and Digital Forensics, Tohoku University Graduate School of Dentistry, Sendai, Japan.
| | - Keiichi Sasaki
- Division of Dental and Digital Forensics, Tohoku University Graduate School of Dentistry, Sendai, Japan; Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Abstract
The effect on quality of life (QOL) of laryngectomy and organ preservation protocols is important in decision making. The aim of this cross-sectional study was to evaluate QOL outcomes of patients with advanced laryngeal tumors who were treated with laryngectomy or organ preservation protocols in Latin America. A total of 35 patients from three oncology units were enrolled. Patients with stage III/IV laryngeal cancer who were treated using organ preservation protocols or laryngectomy were assessed with the University of Washington QOL Questionnaire. The most important domains that affected QOL for both groups were speech and activity. In the laryngectomy group, the next most important domains were appearance, taste, pain, and recreation, whereas in the organ preservation group, they were saliva, recreation, mood, and swallowing. There were no statistically or clinically significant differences in the global score or the 7 days of QOL assessments before patients were interviewed. Global QOL assessments were similar when comparing laryngectomy and organ preservation protocols.
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Affiliation(s)
- Jessie C Everaert
- Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium
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Montes-Jovellar L, Carrillo A, Muriel A, Barbera R, Sanchez F, Cobeta I. Translation and validation of the MD Anderson Dysphagia Inventory (MDADI) for Spanish-speaking patients. Head Neck 2018; 41:122-129. [PMID: 30549341 DOI: 10.1002/hed.25478] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 03/11/2018] [Accepted: 07/05/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The main objective of this study was to perform the adaptation and cultural translation and validation of the MD Anderson Dysphagia Inventory (MDADI) questionnaire for the Spanish language. METHODS A total of 69 patients were diagnosed with head and neck cancer treated with surgery; radiotherapy and chemoradiotherapy were included. MDADI was translated and a feasibility, internal consistency, test-retest reliability, and construct validity were assessed. RESULTS The mean overall score of the MDADI was 51.9 (18-85). Internal consistency for total score was 0.908. The overall score of intraclass correlation coefficient was 0.98 and kappa coefficient scores were almost perfect (test-retest reliability). All domains of MDADI were significantly correlated with physical and mental domains of the SF-12. Construct validity was also evaluated with food texture measures, and with TNM classification. CONCLUSION The translation and validation of the Spanish version of the MDADI was performed and can be considered an important patient-reported outcomes tool for dysphagia-related quality of life.
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Affiliation(s)
- Lourdes Montes-Jovellar
- Otolaryngology Department, Head and Neck section, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Alvaro Carrillo
- Otolaryngology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Alfonso Muriel
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERESP, Madrid, Spain
| | - Rafael Barbera
- Otolaryngology Department, Chief of Head and Neck section, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Fatima Sanchez
- Otolaryngology Department, Head and Neck section, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Ignacio Cobeta
- Otolaryngology Department, Chief of the Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
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20
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Ionescu R, Bertesteanu SV, Popescu RC, Balalau C, Scaunasu RV, Popescu B. Standard or individualized quality of life for larynx cancer patients? JOURNAL OF CLINICAL AND INVESTIGATIVE SURGERY 2018. [DOI: 10.25083/2559.5555/3.2/62.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Locally advanced larynx cancer benefits from curative surgery therapy. Clinical trials have been proposed for assessing the quality of life for patients with larynx malignant neoplasia who underwent radical surgery. The removal of the “voice box” is known to have great impact on the social reintegration of these patients as well as psychological distress. The presence of tracheostomy and voice impairment are two of the major issues that need to be thought of by patients that will have a total laryngectomy. The quality of life is a multi-dimensional subjective and personal concept which includes normal physical activity, looks, psychological status, somatic symptoms and, non the less, sexual activity. Cancer free survival intervals for patients with larynx cancer must be evaluated physical and psychological modifications with particular considerations to stress, anxiety and depression related symptoms and to functional rehabilitation adaptation regarding swallowing and speech. Oncology surgeons must consider that QoL is impaired in all patients with larynx cancer that benefit from total laryngectomy. However, there is evidence presented below that the difference in QoL parameters is small when comparing radical surgery, total laryngectomy, and larynx conservation by radio and chemotherapy.
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Thrasyvoulou G, Vlastarakos PV, Thrasyvoulou M, Sismanis A. Horizontal (vs. vertical) closure of the neo-pharynx is associated with superior postoperative swallowing after total laryngectomy. EAR, NOSE & THROAT JOURNAL 2018; 97:E31-E35. [PMID: 29940691 DOI: 10.1177/0145561318097004-502] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We conducted a cross-sectional study to compare the horizontal and vertical methods used in the surgical closure of the neo-pharynx after total laryngectomy in terms of their effect on swallowing function, swallowing-related quality of life (QOL), and overall QOL. We also assessed the potential influence of age (≤64 vs. ≥65 yr) and the type of treatment modality (primary, salvage, or total laryngectomy with radiotherapy) on outcomes. Our final study population was made up of 34 patients-31 men and 3 women, aged 49 to 89 years (mean: 66.8)-who had undergone a total laryngectomy. One year after surgery, all patients were asked to complete the M.D. Anderson dysphagia inventory (MDADI), which quantifies swallowing function and swallowing-related QOL, and the University of Washington quality-of-life questionnaire (UW-QOL), which quantifies overall QOL. Of the 34 patients, 16 had undergone a horizontal surgical closure of their neo-pharynx and 18 a vertical closure. According to the MDADI, patients in the horizontal group experienced significantly better swallowing function/QOL; the mean composite MDADI scores were 91.5 in the horizontal group and 68.3 in the vertical group (p = 0.005). We found no significant difference in terms of overall QOL, as the respective mean UW-QOL scores were 81.0 and 80.8 (p = 0.93). The population correlation coefficient was positive in both groups, but more so in the horizontal group (ρhorizontal = 0.876 and ρvertical = 0.676). Neither age nor the type of treatment modality employed influenced swallowing function/QOL (page = 0.10, ptreatment modality = 0.78) or overall QOL (page = 0.08, ptreatment modality = 0.59). We conclude that horizontal closure of the neo-pharynx is superior to vertical closure in terms postoperative swallowing function/QOL but not overall QOL.
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Gallo O, Locatello LG, Larotonda G, Napoleone V, Cannavicci A. Nomograms for prediction of postoperative complications in open partial laryngeal surgery. J Surg Oncol 2018; 118:1050-1057. [DOI: 10.1002/jso.25232] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 08/20/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Oreste Gallo
- Department of Surgery and Translational Medicine; Division of Otolaryngology, University of Florence; Firenze Italy
| | - Luca Giovanni Locatello
- Department of Surgery and Translational Medicine; Division of Otolaryngology, University of Florence; Firenze Italy
| | - Guglielmo Larotonda
- Department of Surgery and Translational Medicine; Division of Otolaryngology, University of Florence; Firenze Italy
| | - Vincenzo Napoleone
- Biodigita - Biostatistical Analysis Section, Gorgia Study Institute; Firenze Italy
| | - Angelo Cannavicci
- Department of Surgery and Translational Medicine; Division of Otolaryngology, University of Florence; Firenze Italy
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Sanabria A, Sánchez D, Chala A, Alvarez A. Quality of life in patients with larynx cancer in Latin America: Comparison between laryngectomy and organ preservation protocols. EAR, NOSE & THROAT JOURNAL 2018; 97:83-90. [PMID: 29554402 DOI: 10.1177/014556131809700323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The effect on quality of life (QOL) of laryngectomy and organ preservation protocols is important in decision making. The aim of this cross-sectional study was to evaluate QOL outcomes of patients with advanced laryngeal tumors who were treated with laryngectomy or organ preservation protocols in Latin America. A total of 35 patients from three oncology units were enrolled. Patients with stage III/IV laryngeal cancer who were treated using organ preservation protocols or laryngectomy were assessed with the University of Washington QOL Questionnaire. The most important domains that affected QOL for both groups were speech and activity. In the laryngectomy group, the next most important domains were appearance, taste, pain, and recreation, whereas in the organ preservation group, they were saliva, recreation, mood, and swallowing. There were no statistically or clinically significant differences in the global score or the 7 days of QOL assessments before patients were interviewed. Global QOL assessments were similar when comparing laryngectomy and organ preservation protocols.
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Affiliation(s)
- Alvaro Sanabria
- Department of Surgery, Universidad de Antioquia, Calle 67 No. 53-108, Medellin, Colombia.
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Bickford J, Coveney J, Baker J, Hersh D. Validating the Changes to Self-identity After Total Laryngectomy. Cancer Nurs 2018; 42:314-322. [PMID: 29846191 DOI: 10.1097/ncc.0000000000000610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND A total laryngectomy often prolongs life but results in long-term disablement, disfigurement, and complex care needs. Current clinical practice addresses the surgical options, procedures, and immediate recovery. Less support is available longer-term despite significant changes to aspects of personhood and ongoing medical needs. OBJECTIVE The aim of this study was to explore the experience of living with and/or supporting individuals with a laryngectomy at least 1 year after surgery. METHODS Constructivist grounded theory methods and symbolic interactionism were used to guide collection and analysis of interview data from 28 participants (12 individuals with a laryngectomy, 9 primary supporters, and 7 health professionals). RESULTS The phenomena of "validating the altered self after total laryngectomy" highlighted how individuals, postlaryngectomy, navigate and negotiate interactions due to the disruption of their self-expression, related competencies, and roles. Several reframing patterns representing validation of the self emerged from the narratives. They were as follows: destabilized, resigned, resolute, and transformed. The data describe the influence of the processes of developing competence and building resilience, combined with contextual factors, for example, timing and turning points; being supported; and personal factors on these reframing patterns. CONCLUSION The findings further our understanding of the long-term subjective experience of identity change after laryngectomy and call attention to the persisting need for psychosocial support. IMPLICATIONS FOR PRACTICE This research provides important evidence for evaluating and strengthening the continuum of services (specialist to community) and supporting social participation, regardless of communication method, and for competency training for all involved to optimize person-centered practices.
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Affiliation(s)
- Jane Bickford
- Authors Affiliations: College of Nursing and Health Sciences, Flinders University, Adelaide (Dr Bickford and Adjunct Associate Professor Baker and Professor Coveney); and School of Medicine and Health Sciences, Edith Cowan University, Western Australia (Associate Professor Hersh)
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Epstein JB, Smith DK, Villines D, Parker I, Hameroff J, Hill BR, Murphy BA. Patterns of oral and dental care education and utilization in head and neck cancer patients. Support Care Cancer 2018; 26:2591-2603. [DOI: 10.1007/s00520-018-4099-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 02/07/2018] [Indexed: 02/07/2023]
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Prospective evaluation of quality of life in patients with head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:350-357. [DOI: 10.1016/j.oooo.2016.11.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 11/15/2016] [Accepted: 11/28/2016] [Indexed: 11/22/2022]
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Lee YH, Lai YH, Yueh B, Chu PY, Chen YJ, Chen SC, Wang CP. Validation of the University of Washington Quality of Life Chinese Version (UWQOL-C) for head and neck cancer patients in Taiwan. J Formos Med Assoc 2017; 116:249-256. [PMID: 28214178 DOI: 10.1016/j.jfma.2017.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/PURPOSE The purposes of this three-phase study were to: (1) translate and evaluate the burden, content, and face validity of the Chinese version of the University of Washington Quality of Life Scale, version 4 (UWQOL-v4-C); and (2) examine the psychometric properties of the UWQOL-v4-C in oral cancer and laryngeal cancer patients in Taiwan. METHODS This instrument translation and validation study was part of a major research project. The first phase of this study developed and validated the content of the UWQOL-v4-C. The second phase sought to validate the internal consistency, reliability, and construct and discriminant validity in two major groups of head and neck cancer (HNC) patients: oral cavity cancers (n=109) and laryngeal cancer (n=102). Construct validity was measured using theoretically supported correlations between the UWQOL and related constructs. Discriminant validity was also assessed. In the third phase, test-retest reliability of UWQOL-v4-C was examined through the 1-week interval in another group of HNC patients (n=50). RESULTS The translated UWQOL-v4-C demonstrated satisfactory face validity, content validity, and minimal patient burden. Additionally, the UWQOL-v4-C showed excellent construct validity in patient testing, supported by significant correlations between the UWQOL-v4-C and hypothesized constructs, including generic measures of QOL and performance status. The developed scale correlated inversely with symptom severity and psychological distress. Discriminant validity was seen in patients with different cancer diagnoses, stages, and treatments. Finally, excellent stability was supported by a 1-week test-retest reliability of 0.88. CONCLUSION The UWQOL-v4-C was a brief, low-burden, and valid instrument to measure the QOL in Chinese-speaking HNC patients in Taiwan.
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Affiliation(s)
- Yun-Hsiang Lee
- Department of Nursing, Mackay Medical College, Taipei, Taiwan
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan; Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan.
| | - Bevan Yueh
- Department of Otolaryngology, Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Pen-Yuan Chu
- Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Otolaryngology, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Ju Chen
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
| | - Shu-Ching Chen
- Department of Nursing, Chang Gung University of Science and Technology, Kweishan, Taoyuan, Taiwan
| | - Cheng-Ping Wang
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
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Wiegand S. Evidence and evidence gaps of laryngeal cancer surgery. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2016; 15:Doc03. [PMID: 28025603 PMCID: PMC5169076 DOI: 10.3205/cto000130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Surgical treatment of laryngeal cancer has been established for decades. In addition to total laryngectomy, which was first performed in 1873, a large number or organ preservation surgical techniques, like open partial laryngectomy, transoral laser microsurgery, and transoral robotic surgery have been developed. Studies on laryngeal cancer surgery are mainly retrospective case series and cohort studies. The evolution of chemoradiation protocols and their analysis in prospective randomized trials have led to an increasing acceptance of non-surgical treatment procedures. In addition to an improvement of prognosis, in recent years the preservation of function and maintenance of life quality after primary therapy of laryngeal cancer has increasingly become the focus of therapy planning. Significant late toxicity after chemoradiation has been identified as an important issue. This leads to a reassessment of surgical concepts and initiation of studies on laryngeal cancer surgery which was additionally stimulated by the advent of transoral robotic surgery in the US. Improving the evidence base of laryngeal cancer surgery by successful establishment of surgical trials should be the future goal.
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Affiliation(s)
- Susanne Wiegand
- Department of Otolaryngology, Head & Neck Surgery, University Hospital of Leipzig, Germany
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The development of an ICF-based clinical guideline and screening tool for the standardized assessment and evaluation of functioning after head and neck cancer treatment. Eur Arch Otorhinolaryngol 2016; 274:1035-1043. [PMID: 27695934 DOI: 10.1007/s00405-016-4317-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 09/22/2016] [Indexed: 11/12/2022]
Abstract
The assessment and evaluation of functioning and quality of life after tumor treatment in head and neck cancer (HNC) are considered as essential aspects of clinical routine and studies. A huge number of instruments are available that have been designed to evaluate functioning and quality of life after HNC treatment. The diversity of these instruments in terms of content, response options and administration hinders the comparability of available studies and the performance of meta-analyses. The objective of this paper is to inform about the development of a screening tool for the standardized assessment and evaluation of functioning based on the International Classification of Functioning, Disability and Health (ICF) Core Set for HNC. We followed a multi-step approach including (1) preparatory studies to identify and preselect suitable instruments for the assessment of functioning, (2) a decision-making process to agree on an ICF-based clinical guideline including instruments assessing functioning and (3) the development of a computer-based standardized screening tool to assess and evaluate functioning based on this guideline in clinical routine. Twenty-one experts participated in a consensus meeting and decided on instruments to be included in an ICF-based clinical guideline and screening tool for the assessment and evaluation of functioning in HNC patients in cancer treatment. The chosen instruments cover all aspects of the ICF Core Set for HNC addressing therapy control, pain, food intake/swallowing, voice/speech/breathing, other somatic complaints and psychosocial aspects. The screening tool contains patient-reported outcome measures and a clinician's checklist. It has to be further tested in clinical practice.
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Eadie TL, Otero DS, Bolt S, Kapsner-Smith M, Sullivan JR. The Effect of Noise on Relationships Between Speech Intelligibility and Self-Reported Communication Measures in Tracheoesophageal Speakers. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2016; 25:393-407. [PMID: 27379754 PMCID: PMC5270639 DOI: 10.1044/2016_ajslp-15-0081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 10/29/2015] [Accepted: 12/22/2015] [Indexed: 05/29/2023]
Abstract
PURPOSE The purpose of this study was to examine how sentence intelligibility relates to self-reported communication in tracheoesophageal speakers when speech intelligibility is measured in quiet and noise. METHOD Twenty-four tracheoesophageal speakers who were at least 1 year postlaryngectomy provided audio recordings of 5 sentences from the Sentence Intelligibility Test. Speakers also completed self-reported measures of communication-the Voice Handicap Index-10 and the Communicative Participation Item Bank short form. Speech recordings were presented to 2 groups of inexperienced listeners who heard sentences in quiet or noise. Listeners transcribed the sentences to yield speech intelligibility scores. RESULTS Very weak relationships were found between intelligibility in quiet and measures of voice handicap and communicative participation. Slightly stronger, but still weak and nonsignificant, relationships were observed between measures of intelligibility in noise and both self-reported measures. However, 12 speakers who were more than 65% intelligible in noise showed strong and statistically significant relationships with both self-reported measures (R2 = .76-.79). CONCLUSIONS Speech intelligibility in quiet is a weak predictor of self-reported communication measures in tracheoesophageal speakers. Speech intelligibility in noise may be a better metric of self-reported communicative function for speakers who demonstrate higher speech intelligibility in noise.
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Eadie TL, Otero D, Cox S, Johnson J, Baylor CR, Yorkston KM, Doyle PC. The relationship between communicative participation and postlaryngectomy speech outcomes. Head Neck 2015; 38 Suppl 1:E1955-61. [PMID: 26714043 DOI: 10.1002/hed.24353] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/04/2015] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine relationships between communicative participation and postlaryngectomy speech outcomes, including listener-rated speech intelligibility and acceptability, and patient-rated speech acceptability and voice handicap. METHODS Thirty-six laryngectomized individuals completed the Communicative Participation Item Bank (CPIB) short form and the Voice Handicap Index-10 (VHI-10). They provided recordings from the Sentence Intelligibility Test (SIT) and a reading passage, and rated their own speech acceptability. Forty-eight inexperienced listeners transcribed the SIT sentences to derive intelligibility scores. Eighteen additional listeners judged the speech acceptability using the rating scales. RESULTS Listeners judged tracheoesophageal speakers as significantly more intelligible and acceptable than electrolaryngeal speakers (p < .05). Speech acceptability was significantly more acceptable to speakers than listeners (p < .05). Weak, nonsignificant relationships were found between communicative participation and listener-rated outcomes. Stronger, significant relationships were found between communicative participation and self-rated speech acceptability and voice handicap (p < .05). CONCLUSION Patient-reported communication outcomes are complementary to listener-rated outcomes. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1955-E1961, 2016.
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Affiliation(s)
- Tanya L Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Devon Otero
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Steven Cox
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
| | - Jordan Johnson
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Carolyn R Baylor
- Rehabilitation Medicine, University of Washington, Seattle, Washington
| | | | - Philip C Doyle
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.,Department of Otolaryngology Head and Neck Surgery, Western University, London, Ontario, Canada
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Rossi VC, Fernandes FL, Ferreira MAA, Bento LR, Pereira PSG, Chone CT. Larynx cancer: quality of life and voice after treatment. Braz J Otorhinolaryngol 2014; 80:403-8. [PMID: 25303815 PMCID: PMC9444604 DOI: 10.1016/j.bjorl.2014.07.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 04/15/2014] [Indexed: 11/24/2022] Open
Abstract
Introduction Treatments for patients with laryngeal cancer often have an impact on physical, social, and psychological functions. Objective To evaluate quality of life and voice in patients treated for advanced laryngeal cancer through surgery or exclusive chemoradiation. Methods Retrospective cohort study with 30 patients free from disease: ten total laryngectomy patients without production of esophageal speech (ES); ten total laryngectomy patients with tracheoesophageal speech (TES), and ten with laryngeal speech. Quality of life was measured by SF-36, Voice-Related Quality of Life (V-RQOL), and Voice Handicap Index (VHI) protocols, applied on the same day. Results The SF-36 showed that patients who received exclusive chemoradiotherapy had better quality of life than the TES and ES groups. The V-RQOL showed that the voice-related quality of life was lower in the ES group. In the VHI, the ES group showed higher scores for overall, emotional, functional, and organic VHI. Discussion Quality of life and voice in patients treated with chemoradiotherapy was better than in patients treated surgically. Conclusion The type of medical treatment used in patients with laryngeal cancer can bring changes in quality of life and voice.
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Affiliation(s)
- Vaneli Colombo Rossi
- Speech Therapy Rehabilitation after Head and Neck Surgery, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
| | - Fernando Laffitte Fernandes
- Discipline of Otorhinolaryngology, Head and Neck, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - Lucas Ricci Bento
- Discipline of Otorhinolaryngology, Head and Neck, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Pablo Soares Gomes Pereira
- Discipline of Otorhinolaryngology, Head and Neck, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Carlos Takahiro Chone
- Discipline of Otorhinolaryngology, Head and Neck, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
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Survival patterns in squamous cell carcinoma of the head and neck: pain as an independent prognostic factor for survival. THE JOURNAL OF PAIN 2014; 15:1015-22. [PMID: 25043982 DOI: 10.1016/j.jpain.2014.07.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 07/02/2014] [Accepted: 07/08/2014] [Indexed: 11/24/2022]
Abstract
UNLABELLED Survival outcomes in patients with squamous cell carcinoma of the head and neck (HNSCC) vary by extent of disease, behavioral factors, and socioeconomic factors. We assessed the extent to which pretreatment pain influences survival in 2,340 newly diagnosed patients with HNSCC, adjusting for disease stage, symptoms, pain medications, comorbidities, smoking, alcohol consumption, age, sex, and race/ethnicity. Patients rated their pain at presentation to the cancer center (0 = "no pain" and 10 = "pain as bad as you can imagine"). Survival time was calculated from the date of diagnosis to the date of death of any cause or last follow-up. Five-year overall survival was calculated for all the variables assessed in the study. Severe pain (≥7) was most prevalent among those with oral cancer (20.4%; pharynx = 18.8%; larynx = 16.1%) and significantly varied by tumor stage, fatigue severity, smoking status, comorbid lung disease, and race (all P < .05) across cancer diagnoses. Overall 5-year survival varied by pain for oral (severe pain = 31% vs nonsevere pain = 52%; P < .001) and pharyngeal cancer (severe pain = 33% vs nonsevere pain = 53%; P < .001). Multivariable analyses showed that pain persisted as an independent prognostic factor for survival. Pain reported prior to treatment should be considered in understanding survival outcomes in HNSCC patients. PERSPECTIVE Pretreatment pain was an independent predictor of survival in a large sample of HNSCC patients even after accounting for tumor node metastasis stage, fatigue, age, race/ethnicity, smoking, and alcohol intake. Therefore, symptoms at presentation and before cancer treatment are important factors to be considered in understanding survival outcomes in HNSCC patients.
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Ge X, Wang W, Zhang P, Wu J. Total laryngectomy pre-operative assessment and education in an Ear, Nose & Throat ward: a best practice implementation project. ACTA ACUST UNITED AC 2014. [DOI: 10.11124/jbisrir-2014-1569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Practice of laryngectomy rehabilitation interventions: a perspective from Hong Kong. Curr Opin Otolaryngol Head Neck Surg 2013; 21:205-11. [PMID: 23572016 DOI: 10.1097/moo.0b013e328360d84e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To review the current practice of rehabilitation for laryngectomees in Hong Kong. RECENT FINDINGS Factors affecting the quality of life of laryngectomees include their performance in speech restoration, the presence of complications of treatment, as well as the availability of psycho-social support. In Hong Kong, more than 90% of laryngectomees have speech restoration by various means, the commonest of which being tracheo-oesophageal puncture and electrolaryngeal speech. However, they face special problems in communication using the current alaryngeal speech modalities, as it is difficult to produce variation in tones, which is important to express different meanings in Cantonese. The responsibility of surgeons to follow-up patients after surgery and the practice of management of common complications after laryngectomy are also discussed. The New Voice Club of Hong Kong promotes self-help and mutual help between laryngectomees, with the aim of helping new members to regain normal speech and to re-integrate into society. Quality-of-life study in Hong Kong shows that although the mean global health score is satisfactory, the social functioning domain is most severely affected after surgery. SUMMARY Cantonese-speaking laryngectomees in Hong Kong are facing unique challenges in speech restoration and re-integration into society after surgery. Surgeons should take the leading role in the multidisciplinary management of these patients.
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Kirschneck M, Sabariego C, Singer S, Tschiesner U. Assessment of functional outcomes in patients with head and neck cancer according to the International Classification of Functioning, Disability and Health Core Sets from the perspective of the multi-professional team: results of 4 Delphi surveys. Head Neck 2013; 36:954-68. [PMID: 23733325 DOI: 10.1002/hed.23399] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 04/11/2013] [Accepted: 05/23/2013] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The International Classification of Functioning, Disability and Health Core Set for Head and Neck Cancer (ICF-HNC) covers the typical spectrum of problems in functioning in head and neck cancer. This study is part of a multistep process to develop practical guidelines in Germany. The purpose of this study was to identify instruments for the assessment of functioning using the ICF-HNC as reference. METHODS Four Delphi surveys with physicians, physiotherapists, psychologists, and social workers were performed to identify which aspects of the ICF-HNC are being treated and which assessment tools are recommended for the assessment of functioning. RESULTS Ninety-seven percent categories of the ICF-HNC were treated by healthcare professionals participating in the current study. Altogether, 33 assessment tools were recommended for therapy monitoring, food intake, pain, further organic problems/laboratory tests, and psychosocial areas. CONCLUSION Although the ICF-HNC is being currently implemented by the head and neck cancer experts, several areas are not covered regularly. Additionally, validated tools were rarely recommended.
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Affiliation(s)
- Michaela Kirschneck
- Department of Medical Informatics, Biometry and Epidemiology - IBE, Chair for Public Health and Health Care Research, Ludwig-Maximilians-University, Munich, Germany
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Reyes-Gibby CC, Swartz MD, Yu X, Wu X, Yennurajalingam S, Anderson KO, Spitz MR, Shete S. Symptom clusters of pain, depressed mood, and fatigue in lung cancer: assessing the role of cytokine genes. Support Care Cancer 2013; 21:3117-25. [PMID: 23852407 DOI: 10.1007/s00520-013-1885-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 06/19/2013] [Indexed: 01/05/2023]
Abstract
PURPOSE Symptom clusters, the multiple, co-occurring symptoms experienced by cancer patients, are debilitating and affects quality of life. We assessed if a panel of immune-response genes may underlie the co-occurrence of severe pain, depressed mood, and fatigue and help identify patients with severe versus non-severe symptom clusters. METHODS Symptoms were assessed at presentation, prior to cancer treatment in 599 newly diagnosed lung cancer patients. We applied cluster analyses to determine the patients with severe versus non-severe symptom clusters of pain, depressed mood, and fatigue. RESULTS Two homogenous clusters were identified. One hundred sixteen patients (19 %) comprised the severe symptom cluster, reporting high intensity of pain, depressed mood, and fatigue and 183 (30 %) patients reported low intensity of these symptoms. Using Bayesian model averaging methodology, we found that of the 55 single nucleotide polymorphisms assessed, an additive effect of mutant alleles in endothelial nitric oxide synthase (-1474 T/A) (posterior probability of inclusion (PPI) = 0.78, odds ratio (OR) = 0.54, 95 % credible interval (CI) = (0.31, 0.93)); IL1B T-31C (PPI = 0.72, OR = 0.55, 95 % CI = (0.31, 0.97)); TNFR2 Met(196)Arg (PPI = 0.70, OR = 1.85, 95 % CI = (1.03, 3.36)); PTGS2 exon 10+837T > C (PPI = 0.69, OR = 0.54, 95 % CI = (0.28, 0.99)); and IL10RB Lys(47)Glu (PPI = 0.68; OR = 1.74; 95 % CI = (1.04, 2.92)) were predictive for symptom clusters. CONCLUSIONS Genetic polymorphisms may facilitate identification of high-risk patients and development of individualized symptom therapies.
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Affiliation(s)
- Cielito C Reyes-Gibby
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Unit 1468, 1155 Pressler Street, Houston, TX, 77030-4009, USA,
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Pierre CS, Dassonville O, Chamorey E, Poissonnet G, Ettaiche M, Santini J, Peyrade F, Benezery K, Sudaka A, Bozec A. Long-term quality of life and its predictive factors after oncologic surgery and microvascular reconstruction in patients with oral or oropharyngeal cancer. Eur Arch Otorhinolaryngol 2013; 271:801-7. [DOI: 10.1007/s00405-013-2592-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 06/05/2013] [Indexed: 10/26/2022]
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Vilaseca I, Ballesteros F, Martínez-Vidal BM, Lehrer E, Bernal-Sprekelsen M, Blanch JL. Quality of life after transoral laser microresection of laryngeal cancer: A longitudinal study. J Surg Oncol 2013; 108:52-6. [PMID: 23609524 DOI: 10.1002/jso.23348] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 03/28/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Isabel Vilaseca
- Department of Otolaryngology; Hospital Clínic; Barcelona Spain
- ENT Surgical Oncology Section; Hospital Clínic; Barcelona Spain
- Faculty of Medicine; University of Barcelona; Barcelona Spain
| | - Ferran Ballesteros
- Department of Otolaryngology; Hospital Clínic; Barcelona Spain
- Department of Otolaryngology; Hospital de Terrassa; Terrassa Spain
| | | | - Eduardo Lehrer
- Department of Otolaryngology; Hospital Clínic; Barcelona Spain
| | - Manuel Bernal-Sprekelsen
- Department of Otolaryngology; Hospital Clínic; Barcelona Spain
- Faculty of Medicine; University of Barcelona; Barcelona Spain
| | - José Luis Blanch
- Department of Otolaryngology; Hospital Clínic; Barcelona Spain
- ENT Surgical Oncology Section; Hospital Clínic; Barcelona Spain
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Nozawa K, Shimizu C, Kakimoto M, Mizota Y, Yamamoto S, Takahashi Y, Ito A, Izumi H, Fujiwara Y. Quantitative assessment of appearance changes and related distress in cancer patients. Psychooncology 2013; 22:2140-7. [DOI: 10.1002/pon.3268] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 10/30/2012] [Accepted: 01/28/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Keiko Nozawa
- Yamano College of Aesthetics; Tokyo Japan
- Cancer Information and Support Center; National Cancer Center Hospital; Tokyo Japan
| | - Chikako Shimizu
- Breast and Medical Oncology Division; National Cancer Center Hospital; Tokyo Japan
| | - Minako Kakimoto
- Breast and Medical Oncology Division; National Cancer Center Hospital; Tokyo Japan
| | - Yuri Mizota
- Center for Cancer Control and Information; National Cancer Center; Tokyo Japan
| | - Seiichiro Yamamoto
- Center for Cancer Control and Information; National Cancer Center; Tokyo Japan
| | - Yumiko Takahashi
- Department of Nursing; National Cancer Center Hospital; Tokyo Japan
| | - Atsuko Ito
- Department of Nursing; National Cancer Center Hospital; Tokyo Japan
| | - Hideko Izumi
- Department of Nursing; National Cancer Center Hospital; Tokyo Japan
| | - Yasuhiro Fujiwara
- Breast and Medical Oncology Division; National Cancer Center Hospital; Tokyo Japan
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Tschiesner U. Preservation of organ function in head and neck cancer. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2012; 11:Doc07. [PMID: 23320059 PMCID: PMC3544204 DOI: 10.3205/cto000089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Preservation of function is a crucial aspect for the evaluation of therapies applied in the field of head and neck cancer. However, preservation of anatomic structures cannot automatically be equated with preservation of function. Functional outcome becomes increasingly important particularly for the evaluation of alternative treatment options with equivalent oncological outcomes.AS A RESULT, PRESENT STUDIES TAKE INTO ACCOUNT THREE TOPIC AREAS WITH VARYING EMPHASIS: (1) the effects of cancer therapy on essential physiological functions, (2) additional therapy-induced side-effects and complications, and (3) health-related quality of life. The present article summarizes vital aspects of clinical research from recent years. Functional outcomes after surgical and non-surgical treatment approaches are presented according to tumor localization and staging criteria. Additional methodological aspects relating to data gathering and documentation as well as challenges in implementing the results in clinical practice are also discussed.
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Affiliation(s)
- Uta Tschiesner
- Clinic for Otorhinolaryngology, Ludwig Maximilians University (LMU) Munich, Munich, Germany
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Pernambuco LDA, Oliveira JHPD, Régis RMFL, Lima LMD, Araújo AMBD, Balata PMM, Cunha DAD, Silva HJD. Quality of life and deglutition after total laryngectomy. Int Arch Otorhinolaryngol 2012; 16:460-5. [PMID: 25991974 PMCID: PMC4432550 DOI: 10.7162/s1809-97772012000400006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Accepted: 08/10/2012] [Indexed: 11/25/2022] Open
Abstract
Introduction: Total laryngectomy creates deglutition disorders and causes a decrease in quality of life Aim: To describe the impact of swallowing and quality of life of patients after total laryngectomy. Method: A case series study. Patients completed a Swallowing and Quality of Life questionnaire composed of 44 questions assessing 11 domains related to quality of life (burden, eating duration, eating desire, frequency of symptoms, food selection, communication, fear, mental health, social functioning, sleep, and fatigue). The analysis was performed using descriptive statistics, including measures of central tendency and variability. Results: The sample comprised 15 patients who underwent total laryngectomy and adjuvant radiotherapy. Of these, 66.7% classified their health as good and 73% reported no restrictions on food consistency. The domains “communication” and “fear” represented severe impact and “eating duration” represented moderate impact on quality of life. The items with lower scores were: longer time to eat than others (domain “eating duration”), cough and cough to remove the liquid or food of the mouth when they are stopped (domain “symptom frequency”), difficulties in understanding (domain “communication”) and fear of choking and having pneumonia (domain “fear”). Conclusion: After total laryngectomy, patients report that swallowing issues have moderate to severe impact in “communication,” “fear,” and “eating duration” domains.
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Affiliation(s)
- Leandro de Araújo Pernambuco
- Master in Health Sciences - Federal University of Pernambuco. Professor - Speech, Language and Hearing Sciences Department - Federal University of Rio Grande do Norte
| | | | | | - Leilane Maria de Lima
- Graduated in Speech, Language and Hearing Science - Federal University of Pernambuco.Speech and Language Pathologist
| | - Ana Maria Bezerra de Araújo
- Specialist in Dysphagia - Federal Council of Speech, Language and Hearing Sciences. Speech and Language Pathologist - Cancer Hospital of Pernambuco
| | - Patrícia Maria Mendes Balata
- Master of Science in Adolescent Health - Pernambuco University. Speech and Language Pathologist. Institute of Human Resources of Pernambuco State
| | | | - Hilton Justino da Silva
- Ph.D in Nutrition - Federal University of Pernambuco. Professor - Speech, Language and Hearing Science Department - Federal University of Pernambuco
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Eadie TL, Day AMB, Sawin DE, Lamvik K, Doyle PC. Auditory-perceptual speech outcomes and quality of life after total laryngectomy. Otolaryngol Head Neck Surg 2012; 148:82-8. [PMID: 23008330 DOI: 10.1177/0194599812461755] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE (1) To determine potential relationships between speech intelligibility, acceptability, and self-reported quality of life (QOL) after total laryngectomy and (2) to determine whether relationships are stronger when QOL is measured by a head and neck cancer-specific or discipline-specific QOL scale. STUDY DESIGN Cross-sectional. SETTING University-based laboratory and speech clinic. SUBJECTS AND METHODS Twenty-five laryngectomized individuals completed disease-specific (University of Washington Quality of Life; UW-QOL) and discipline-specific (Voice Handicap Index-10; VHI-10) QOL scales. They also provided audio recordings that included the Sentence Intelligibility Test (SIT) and a reading passage. Thirty-three listeners transcribed the SIT sentences to yield intelligibility scores. Fifteen additional listeners judged speech acceptability of the reading passage using rating scales. RESULTS The QOL scores were moderate across the UW-QOL physical (mean = 77.63) and social-emotional (mean = 78.02) subscales and the VHI-10 (mean = 17.91). Speech acceptability and intelligibility varied across the samples, with acceptability only moderately related to intelligibility (r = 0.41, P < .05). Relationships were weak between ratings of intelligibility and self-reported QOL (range, r = 0.00-0.22) and weak to moderate between acceptability with QOL (range, r = 0.01-0.46). The only statistically significant, but moderate, relationship was found between speech acceptability with the UW-QOL speech subscore (r = 0.46, P < .05). CONCLUSION Listeners' ratings of speech acceptability and intelligibility were not strongly predictive of disease-specific or voice-related QOL, suggesting that listener-rated and patient-reported outcomes are complementary.
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Affiliation(s)
- Tanya L Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington 98105, USA.
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Azevedo EHM, Montoni N, Gonçalves Filho J, Kowalski LP, Carrara-de Angelis E. Vocal Handicap and Quality of Life After Treatment of Advanced Squamous Carcinoma of the Larynx and/or Hypopharynx. J Voice 2012; 26:e63-71. [DOI: 10.1016/j.jvoice.2011.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Accepted: 02/17/2011] [Indexed: 11/16/2022]
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Eadie TL, Bowker BC. Coping and quality of life after total laryngectomy. Otolaryngol Head Neck Surg 2012; 146:959-65. [PMID: 22307574 DOI: 10.1177/0194599812437315] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate how ways of coping and traditional factors (age, sex, time postlaryngectomy, stage of disease, radiation, alaryngeal speech method) predict global quality of life, head and neck cancer-specific quality of life, and voice-related quality-of-life outcomes after total laryngectomy. STUDY DESIGN Cross-sectional survey. SETTING University-based laboratory and speech clinic. SUBJECTS AND METHODS Sixty-seven individuals who underwent total laryngectomy secondary to cancer were recruited from support groups and professional contacts. Individuals were at minimum 9 months postlaryngectomy. All outcomes were patient reported and included demographic data as well as a number of validated questionnaires: the Ways of Coping-Cancer Version (WOC-CV) scale, the Voice-Related Quality of Life (V-RQOL) scale, and the University of Washington Quality of Life (UW-QOL) composite and global QOL scores. RESULTS Fifty-three individuals identified a stressful aspect of their laryngectomy. As a set, traditional variables (age, time postlaryngectomy, alaryngeal speech method) accounted for only 5% of global QOL scores but between 25% and 30% of the variance of composite UW-QOL and V-RQOL scores. Time postlaryngectomy was the strongest traditional predictor. Ways of coping accounted for 23% to 32% of all QOL scores. Avoidant coping strategies (both cognitive and behavioral escape) were among the strongest predictors of poorer QOL. When traditional variables were combined with ways of coping, they together accounted for 26% to 46% of the variance of QOL outcomes. CONCLUSION Coping is important to consider when evaluating postlaryngectomy outcomes, above and beyond traditionally investigated factors.
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Affiliation(s)
- Tanya L Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington 98105, USA.
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Leib A, Cieza A, Tschiesner U. Perspective of physicians within a multidisciplinary team: Content validation of the comprehensive ICF core set for head and neck cancer. Head Neck 2011; 34:956-66. [DOI: 10.1002/hed.21844] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 05/02/2011] [Accepted: 05/12/2011] [Indexed: 11/11/2022] Open
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Management of total laryngectomy patients over time: from the consultation announcing the diagnosis to long term follow-up. Eur Arch Otorhinolaryngol 2011; 268:1407-19. [DOI: 10.1007/s00405-011-1661-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Accepted: 05/26/2011] [Indexed: 01/22/2023]
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Mak KK, Ho SY, Fong DYT, Lo WS, Lai YK, Lam TH. Norms and demographic differences of the short form-12 health survey version 2 in Chinese adolescents. J Paediatr Child Health 2011; 47:173-82. [PMID: 21244545 DOI: 10.1111/j.1440-1754.2010.01939.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to establish the normative values for the 12-item Short Form Health Survey version 2 (SF-12v2) and examine demographic differences among Hong Kong Chinese adolescents. METHODS A total of 28,981 Hong Kong Chinese adolescents aged 12-18 participated in a school-based survey in 2006-2007. Sex- and age-specific SF-12v2 scores were obtained. Ordinal logistic regression models and linear regression models were used to examine the demographic differences for the eight subscales including physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional and mental health, and two component summary scores of Physical Component Summary and Mental Component Summary. RESULTS The mean (standard deviation) Physical Component Summary score was 50.28 (6.82) for boys and 49.37 (6.47) for girls. The corresponding Mental Component Summary score was 45.86 (9.86) for boys and 44.77 (9.56) for girls. Ceiling effects were observed in some of the eight subscales but not the two component summary scores. Ordinal logistic regression showed that girls had significantly lower scores than boys in most subscales including physical functioning with odds ratio (95% confidence interval) of 0.89 (0.84-0.93); role physical, 0.94 (0.90-0.98); bodily pain, 0.76 (0.73-0.80); general health, 0.55 (0.53-0.57); vitality, 0.72 (0.69-0.75); role emotional, 0.78 (0.74-0.81); and mental health, 0.91 (0.88-0.95). In general, older and non-local-born adolescents had lower component summary scores than their peers. CONCLUSIONS This study has provided norms and identified demographic differences of the Chinese SF-12v2.
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Affiliation(s)
- Kwok-Kei Mak
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Graphical modeling can be used to illustrate associations between variables describing functioning in head and neck cancer patients. J Clin Epidemiol 2011; 64:885-92. [PMID: 21316921 DOI: 10.1016/j.jclinepi.2010.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2010] [Revised: 10/26/2010] [Accepted: 11/24/2010] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine the associations between variables of functioning measured by the International Classification of Functioning, Disability and Health (ICF) in head and neck cancer (HNC) patients by means of graphical modeling. STUDY DESIGN AND SETTING Graphical modeling was used on a data set of a cross-sectional multicentric study of 145 patients with HNC. Functioning was qualified using the extended ICF checklist. Multiple imputation was used to handle missing data. The least absolute shrinkage and selection operator for generalized linear models was used to identify conditional associations between the ICF categories. Bootstrap aggregating was used to enhance the accuracy and validity of model selection. RESULTS The resulting graph shows largely meaningful associations between the ICF categories. One central point could be visualized consisting of a circular path of d330 Speaking, d350 Conversation, b510 Ingestion functions, s320 Structure of mouth, and b310 Voice functions. Another important structure in the graph were the bow-shaped associations beginning with d335 Producing nonverbal messages to b130 Energy and drive functions. CONCLUSION Graphical modeling can be used to describe associations between different areas of functioning in HNC patients. They found associations can be the basis for improved rehabilitation and gives a deeper understanding of functioning in HNC patients.
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