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Saleem A, Noel CW, Hueniken K, Grewal R, Kwinter A, Peralta G, de Almeida JR, Goldstein DP. Quantifying Neck Fibrosis: Establishing the Domain Structure of the Neck Fibrosis Scale. Laryngoscope 2023; 133:2198-2202. [PMID: 36479707 DOI: 10.1002/lary.30497] [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: 09/09/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE We recently described the development of the Neck Fibrosis Scale (NFS). In this submission, we confirm domain structure and validate a scoring system for the NFS. STUDY DESIGN Prospective cross-sectional study. METHODS Between January 2020 and December 2021, 127 head and neck cancer patients with varying degrees of cutaneous neck fibrosis completed the original 15 item NFS. Exploratory factor analysis was used to identify optimal groupings with similar underlying factors. The association between the domains of the NFS and various measures of neck morbidity (i.e., construct validity) were assessed using gamma regression. RESULTS Exploratory factor analysis confirmed 13 of the 15 items from the NFS mapped onto two factors, which were labelled 'physical' and 'emotional' domains. Of the remaining two items, 'energy' did not load uniquely onto one factor and was removed. 'Neck-swelling' did not load on either factor (loadings <0.3) but was retained within the physical domain based on clinical importance. This resulted in a revised 14-item questionnaire. Internal consistency for these two domains was high (>0.8, p < 0.01). Both the physical and emotional domains of the revised NFS show strong correlation with the neck dissection impairment index and neck range of motion. The physical domain strongly correlated with neck elasticity (0.902 [95%CI 0.839-0.972], p < 0.01). Patients receiving multimodal therapy had physical domain scores that were 31.6% [95% 13.9-51.8] higher (worse) than unimodal therapy patients. CONCLUSIONS A domain structure and scoring strategy have been developed for the NFS. Future efforts should be directed toward an evaluation of responsiveness. LEVEL OF EVIDENCE NA Laryngoscope, 133:2198-2202, 2023.
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Affiliation(s)
- Ahmed Saleem
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Christopher W Noel
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Katrina Hueniken
- Department of Biostatistics, Princess Margaret hospital, Toronto, Ontario, Canada
| | - Rajan Grewal
- Department of Otolaryngology - Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Adam Kwinter
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Giselle Peralta
- Department of Otolaryngology - Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - John R de Almeida
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology - Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - David P Goldstein
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
- Department of Otolaryngology - Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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Riechelmann H, Dejaco D, Steinbichler TB, Lettenbichler-Haug A, Anegg M, Ganswindt U, Gamerith G, Riedl D. Functional Outcomes in Head and Neck Cancer Patients. Cancers (Basel) 2022; 14:cancers14092135. [PMID: 35565265 PMCID: PMC9099625 DOI: 10.3390/cancers14092135] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary With increasing long-term survivorship of head and neck cancer (HNC), the functional outcomes are gaining importance. Recently, a tool for the rapid clinical assessment of the functional status in HNC-patients based on observable clinical criteria, termed “HNC-Functional InTegrity (FIT) Scales, was validated. Here, the functional outcomes of 681 newly diagnosed HNC-patients were reported using the HNC-FIT Scales. A normal/near-normal outcome in all six functional domains was observed in 61% of patients, with individual scores of 79% for food intake, 89% for breathing, 84% for speech, 89% for pain, 92% for mood, and 88% for neck and shoulder mobility. Clinically relevant impairment in at least one functional domain was observed in 30% of patients, and 9% had loss of function in at least one functional domain. Thus, clinically relevant persistent functional deficits in at least one functional domain must be expected in 40% of HNC-patients. The treatment of these functional deficits is an essential task of oncologic follow-up. Abstract With the increase in long-term survivorship of head and neck cancer (HNC), the functional outcomes are gaining importance. We reported the functional outcomes of HNC patients using the HNC-Functional InTegrity (FIT) Scales, which is a validated tool for the rapid clinical assessment of functional status based on observable clinical criteria. Patients with newly diagnosed HNC treated at the Medical University of Innsbruck between 2008 and 2020 were consecutively included, and their status in the six functional domains of food-intake, breathing, speech, pain, mood, and neck and shoulder mobility was scored by the treating physician at oncological follow-up visits on a scale from 0 (loss of function) to 4 (full function). HNC-FIT scales were available for 681 HNC patients at a median of 35 months after diagnosis. The response status was complete remission in 79.5%, 18.1% had recurrent or persistent disease, and 2.4% had a second primary HNC. Normal or near-normal scores (3 and 4) were seen in 78.6% for food intake, 88.7% for breathing, 83.7% for speech, 89% for pain, 91.8% for mood, and 87.5% for neck and shoulder mobility. A normal or near-normal outcome in all six functional domains was observed in 61% of patients. Clinically relevant impairment (score 1–2) in at least one functional domain was observed in 30%, and 9% had loss of function (score 0) in at least one functional domain. The main factors associated with poor functional outcome in a multivariable analysis were recurrence or persistent disease, poor general health (ASA III and IV), and higher T stage. Particularly, laryngeal and hypopharyngeal tumors impaired breathing and speech function, and primary radiation therapy or concomitant systemic therapy and radiotherapy worsened food intake. Clinically relevant persistent functional deficits in at least one functional domain must be expected in 40% of the patients with HNC. The treatment of these functional deficits is an essential task of oncologic follow-up.
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Affiliation(s)
- Herbert Riechelmann
- Department of Otorhinolaryngology—Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (H.R.); (T.B.S.); (A.L.-H.); (M.A.)
| | - Daniel Dejaco
- Department of Otorhinolaryngology—Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (H.R.); (T.B.S.); (A.L.-H.); (M.A.)
- Correspondence: ; Tel.: +43-512-504-23142
| | - Teresa Bernadette Steinbichler
- Department of Otorhinolaryngology—Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (H.R.); (T.B.S.); (A.L.-H.); (M.A.)
| | - Anna Lettenbichler-Haug
- Department of Otorhinolaryngology—Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (H.R.); (T.B.S.); (A.L.-H.); (M.A.)
| | - Maria Anegg
- Department of Otorhinolaryngology—Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (H.R.); (T.B.S.); (A.L.-H.); (M.A.)
| | - Ute Ganswindt
- Department of Radiation-Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Gabriele Gamerith
- Internal Medicine V, Department of Hematology & Oncology, Medical University Innsbruck, 6020 Innsbruck, Austria;
| | - David Riedl
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
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Applying the Microvascular Anastomotic Coupler Device to End-to-side Venous Anastomosis in Reconstructive Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4018. [PMID: 35047322 PMCID: PMC8759618 DOI: 10.1097/gox.0000000000004018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/03/2021] [Indexed: 11/25/2022]
Abstract
Background: Microsurgical vascular anastomosis plays an important role in successful free-tissue transfer. The Microvascular Anastomotic Coupler Device (MACD) aims to simplify anastomosis and decrease the time spent on this step, thereby reducing surgeon stress and improving the overall quality of the surgery, especially when venous end-to-side anastomosis is required. Our comparative retrospective cohort study aimed to determine the effect of this widely used device on anastomosis times and complications in head and neck/esophageal reconstruction cases involving venous end-to-side anastomosis using the internal jugular vein as the recipient vessel. Methods: All consecutive patients who underwent head and neck/esophageal reconstruction with hand-sewn or MACD-mediated venous end-to-side anastomosis using the internal jugular vein by three experienced microsurgeons in our tertiary-care hospital in 2012–2020 were identified. Venous anastomosis times and venous trouble cases were recorded. Results: Of the 191 cases, 44 and 147 underwent hand-sewn and MACD-mediated anastomosis respectively. The average venous anastomosis times of these groups were 31 and 11 minutes, respectively. Venous trouble was observed in two hand-sewn (4.5%) and four MACD (2.7%) cases, respectively. Vein twisting and improper coupler placement were the causes in the latter four cases. Conclusions: This study confirmed that MACD simplifies end-to-side venous anastomosis and reduces the time spent on this procedure. Also, for safer anastomosis, it is necessary to pay attention to preventing twisting and improper coupler placement when using MACD. We believe the MACD can improve the quality of reconstructive surgery.
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Noel CW, Kwinter A, Mifsud M, Ringash J, Waldron J, Chepeha DB, Irish JC, Martino R, Gomes A, Aziza E, de Almeida JR, Goldstein DP. Quantifying Neck Fibrosis and Its Functional Implications: Development of the Neck Fibrosis Scale. Laryngoscope 2021; 132:1015-1021. [PMID: 34652823 DOI: 10.1002/lary.29897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/21/2021] [Accepted: 09/29/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Despite increasing recognition of the importance of functional outcomes for patients with head and neck cancer, post-treatment neck fibrosis remains poorly understood. We sought to develop and validate a patient reported outcome measure for head and neck cancer patients with neck fibrosis. STUDY DESIGN Prospective multiphase cross-sectional study. METHODS To guide instrument development, we employed the World Health Organization International Classification of Functioning, Disability and Health as our conceptual framework. Items were generated using a composite strategy consisting of patient focus groups, literature review, and expert opinion from a multidisciplinary group. Candidate items were reduced through the item impact method. Preliminary psychometric properties of the finalized instrument were evaluated through measures of internal consistency, test-retest reliability, and construct validity. RESULTS Four in person focus groups were held with 13 head and neck cancer patients. The process of item generation led to 221 relevant citations and 68 unique items. An additional 17 items were identified from review of existing neck disability questionnaires and expert opinion. A draft instrument with 25 candidate items was generated and reduced to its final 15-item scale using item impact method. Early psychometric testing revealed excellent internal consistency (Cronbach's alpha = 0.95) and test-retest reliability [ICC = 0.95]. Internal consistency at the item level was good (>0.7) for 11/15 individual items. Four separate constructs were evaluated. Three of the four constructs matched our a priori hypotheses. CONCLUSION The Neck Fibrosis Scale demonstrates preliminary reliability and validity for discriminate use. Further research is needed to confirm dimensionality and assess responsiveness. LEVEL OF EVIDENCE NA Laryngoscope, 2021.
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Affiliation(s)
- Christopher W Noel
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Adam Kwinter
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Matthew Mifsud
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, U.S.A
| | - Jolie Ringash
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - John Waldron
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Douglas B Chepeha
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Jonathan C Irish
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Rosemary Martino
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Speech Language Pathology, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Andrea Gomes
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Elana Aziza
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - John R de Almeida
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - David P Goldstein
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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5
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[Functional outcome after transmandibular resection and primary chemoradiation in advanced oropharyngeal squamous cell carcinoma]. HNO 2021; 69:110-121. [PMID: 32929521 PMCID: PMC7862514 DOI: 10.1007/s00106-020-00930-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Ziel der Arbeit In dieser Studie wurden die funktionellen Ergebnisse nach transmandibulärer Resektion und Rekonstruktion mittels mikrovaskulär anastomosiertem Radialistransplantat (TMR+Tx) gegenüber einer primären Radiochemotherapie (pRCT) bei fortgeschrittenen orophayngealen Plattenepithelkarzinomen (OPSCC) verglichen. Methoden Es erfolgte ein Vergleich zwischen 50 OPSCC-Patienten mit TMR+Tx und 50 OPSCC-Patienten mit pRCT. Die Wasserschluckzeit war als primärer Endpunkt definiert. Der Saxon-Test, die maxillomandibuläre Distanz, der Mallampati-Score, der Quotient aus Körpergröße zu Gewicht, eine nasale Penetration, das Vorhandensein einer Ernährungssonde/Tracheostomie sowie 4 validierte Fragebögen (Visuelle Analogskala zur Mundtrockenheit, Sicca VAS; MD Anderson Dysphagia Inventory, MDADI; Voice Handicap Index, VHI; European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Head and Neck Cancer – 35 Items, QLQ-H&N35) dienten als sonstige Endpunkte zur Beurteilung der Funktion und Lebensqualität. Ergebnisse Die Gesamtkohorte an operierten Patienten zeigte eine erhöhte Rate an nasaler Penetration (p < 0,0001), was mit einer verlängerten Wasserschluckzeit verbunden war (p < 0,05). Durch eine modifizierte Rekonstruktion des Weichgaumens wurde die nasale Penetration in der chirurgisch therapierten Gruppe im Vergleich zur klassischen Rekonstruktion signifikant reduziert (p = 0,0001). Patienten mit pRCT litten signifikant stärker an einer Xerostomie (Saxon-Test) als Patienten nach TMR+Tx und Adjuvanz (p = 0,001). In den Fragebögen zur Funktionalität und Lebensqualität zeigte sich kein Unterschied zwischen den Gruppen. Schussfolgerung Die TMR+Tx mit modifizierter Rekonstruktion und adjuvante Therapie zeigte gegenüber der pRCT vergleichbare funktionelle Ergebnisse.
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6
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You Q, Jing X, Fan S, Wang Y, Yang Z. Comparison of functional outcomes and health-related quality of life one year after treatment in patients with oral and oropharyngeal cancer treated with three different reconstruction methods. Br J Oral Maxillofac Surg 2020; 58:759-765. [PMID: 32532572 DOI: 10.1016/j.bjoms.2020.01.010] [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: 03/20/2019] [Accepted: 01/13/2020] [Indexed: 11/30/2022]
Abstract
We evaluated the functional outcomes and health-related quality of life (HRQoL) of 117 patients (who had had primary operations for oral and oropharyngeal squamous cell carcinoma) using the University of Washington Quality of Life Questionnaire version 4 (UW- QOL V4), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire version 3 (EORTC QLQ-C30 v3) and Head and Neck version 1 (EORTC H&N35 v1). The patients were divided into groups according to the reconstruction techniques used: primary closure, submental island pedicled flap (SIPF), and radial forearm free flap (RFFF). Patients who had reconstruction with RFFF had better HRQoL as measured by swallowing, mastication, speaking, and overall score, than the primary closure group (p<0.05). There was no significant difference (p>0.05) between the RFFF and SIPF groups in overall QOL one year postoperatively. The HRQoL of the SIPF group was also better than that of the primary closure group in terms of mastication, speaking, and loss of appetite. Swallowing, mastication, and speaking are major factors that affect the HRQoL of patients one year after operation for oral and oropharyngeal cancer. Flap reconstruction can improve patients' QoL postoperatively. They can regain their ability to speak and swallow through training, and the importance of this issue must be addressed postoperatively.
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Affiliation(s)
- Q You
- Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, China.
| | - X Jing
- Branch of Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510250, China.
| | - S Fan
- Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, China.
| | - Y Wang
- Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, China.
| | - Z Yang
- Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, China.
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7
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Lee YH, Goo-Yoshino S, Lew HL, Chi WC, Yen CF, Liao HF, Chen SC, Liou TH. Social participation in head and neck cancer survivors with swallowing disorder: World Health Organization Disability Assessment Schedule 2.0 study. Head Neck 2019; 42:905-912. [PMID: 31886608 DOI: 10.1002/hed.26062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 11/17/2019] [Accepted: 12/17/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Social function and quality of life were negatively impacted by the sequelae of treatment for the disease in the head and neck cancer survivor with swallowing disorder. METHOD Data from a total of 1023 survivors between July 2012 and November 2017 were collected from the Taiwan Data Bank of Persons with Disability. Nonparametric rank F test was used to analyze the influence of different variables on social participation. RESULTS (a) All WHODAS (World Health Organization Disability Assessment Schedule) 2.0 scores revealed significantly increased difficulty when swallowing impairment increased (P < .001). (b) Unemployment, institutionalization, severity of swallowing impairment, cancer sites, and WHODAS 2.0 score of domains 1 to 4 were negatively related to social participation, while living in rural area is related to increased social participation. CONCLUSIONS Social participation was negatively affected by many variables in this population. Among these variables, cancer sites and WHODAS 2.0 score of domains 1 to 4 were the strongest factors.
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Affiliation(s)
- Yu-Hao Lee
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shari Goo-Yoshino
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Henry L Lew
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii.,Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Wen-Chou Chi
- School of Occupational Therapy, Chungshan Medical University, Taichung, Taiwan
| | - Chia-Feng Yen
- Department of Public Health, Tzu Chi University, Hualien, Taiwan
| | - Hua-Fang Liao
- Taiwan Association of Child Development and Early Intervention, Hualien City, Taiwan.,School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shih-Ching Chen
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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8
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Hoffmann TK. [Oncologic treatment concepts for head and neck cancer : Important results from the world's largest cancer congress, 2019]. HNO 2019; 67:896-897. [PMID: 31768584 DOI: 10.1007/s00106-019-00772-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- T K Hoffmann
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
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9
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Werner J, Hüllner MW, Rupp NJ, Huber AM, Broglie MA, Huber GF, Morand GB. Predictive Value of Pretherapeutic Maximum Standardized Uptake Value (Suv max) In Laryngeal and Hypopharyngeal Cancer. Sci Rep 2019; 9:8972. [PMID: 31222167 PMCID: PMC6586936 DOI: 10.1038/s41598-019-45462-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 06/07/2019] [Indexed: 12/15/2022] Open
Abstract
The aim of the study was to evaluate whether pretherapeutic metabolic tumor parameters from 18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging could predict larynx preservation in laryngeal and hypopharyngeal cancer patients prior to primary chemoradiation. Tumor metabolic parameters [maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were retrospectively assessed in a consecutive cohort of laryngeal and hypopharyngeal cancer patients undergoing primary (chemo-)radiation. Main outcome measures were larynx preservation and survival. The study included 97 patients with a median follow-up of 32 months (IQR 20-54.5). For hypopharyngeal cancer, multivariable analysis showed that patients with a primary tumor's SUVmax > 9.5 entailed a higher risk of undergoing salvage pharyngolaryngectomy after chemoradiation (HR = 8.64, 95% CI = 1.1-67.3, P = 0.040). In laryngeal cancer, SUVmax did not predict the need for salvage laryngectomy. The only predictor for larynx preservation in laryngeal cancer patients was T-classification at initial diagnosis (HR = 6.67, 95% CI = 0.82-53.9, P = 0.039). In conclusion, SUVmax of primary tumor could be used as a predictor of larynx preservation prior to primary chemoradiation in hypopharyngeal cancer patients. This information may be important for patient counseling, as high SUVmax was correlated with reduced probability of larynx preservation. However, in laryngeal cancer patients, SUVmax does not seem to be predictive of outcome.
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Affiliation(s)
- Jonas Werner
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martin W Hüllner
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Alexander M Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
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10
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Stucki G, Pollock A, Engkasan JP, Selb M. How to use the International Classification of Functioning, Disability and Health as a reference system for comparative evaluation and standardized reporting of rehabilitation interventions. Eur J Phys Rehabil Med 2019; 55:384-394. [PMID: 30990004 DOI: 10.23736/s1973-9087.19.05808-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Rehabilitation aims to optimize functioning of persons experiencing functioning limitations. As such the comparative evaluation of rehabilitation interventions relies on the analysis of the differences between the change in patient functioning after a specific rehabilitation intervention versus the change following another intervention. A robust health information reference system that can facilitate the comparative evaluation of changes in functioning in rehabilitation studies and the standardized reporting of rehabilitation interventions is the International Classification of Functioning, Disability and Health (ICF). The objective of this paper is to present recommendations that Cochrane Rehabilitation could adopt for using the ICF in rehabilitation studies by: 1) defining the functioning categories to be included in a rehabilitation study; 2) specifying selected functioning categories and selecting suitable data collection instruments; 3) examining aspects of functioning that have been documented in a study; 4) reporting functioning data collected with various data collection instruments; and 5) communicating results in an accessible, meaningful and easily understandable way. The authors provide examples of concrete studies that underscore these recommendations, whereby also emphasizing the need for future research on the implementation of specific recommendations, e.g. in meta-analysis in systematic literature reviews. Furthermore, the paper outlines how the ICF can complement or be integrated in established Cochrane and rehabilitation research structures and methods, e.g. use of standard mean difference to compare cross-study data collected using different measures, in developing core outcome sets for rehabilitation, and the use of the PICO model.
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Affiliation(s)
- Gerold Stucki
- Department of Health Sciences and Health Policy, University of Luzern, Luzern, Switzerland.,ICF Research Branch, a Cooperation Partner within the WHO Collaborating Center for the Family of International Classifications in Germany, Nottwil, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Alex Pollock
- Unit of Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Julia P Engkasan
- Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia.,University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Melissa Selb
- ICF Research Branch, a Cooperation Partner within the WHO Collaborating Center for the Family of International Classifications in Germany, Nottwil, Switzerland - .,Swiss Paraplegic Research, Nottwil, Switzerland
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11
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Marzouki HZ, Biron VL, Dziegielewski PT, Ma A, Vaz J, Constantinescu G, Harris J, O'Connell D, Seikaly H. The impact of human papillomavirus (HPV) status on functional outcomes and quality of life (QOL) after surgical treatment of oropharyngeal carcinoma with free-flap reconstruction. J Otolaryngol Head Neck Surg 2018; 47:58. [PMID: 30231911 PMCID: PMC6146510 DOI: 10.1186/s40463-018-0301-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 08/26/2018] [Indexed: 12/19/2022] Open
Abstract
Background To determine the impact of Human Papillomavirus (HPV) status on speech, swallowing, and quality of life (QOL) outcomes after surgical treatment of oropharyngeal cancer (OPSCC). Methods A retrospective review of a prospectively collected database of all patients with OPSCC diagnosed and treated from 1998 to 2009. Speech, swallowing, and quality of life data were gathered at 3 different evaluation points. HPV status was determined using p16 positivity as a surrogate marker. Univariate and multivariate statistical analyses were performed to identify whether p16 status is a significant predictor of functional outcome and QOL. Results One hundred twelve patients with OPSCC and known p16 status were treated with primary surgery between 1998 and 2009, with mean age of 56 years. Out of those patients 63 (56%) were p16 positive. Speech intelligibility remained high at 1-year post operation (95.4%). Only 11.5% of the patients required a feeding tube at 1 year after surgery to maintain their daily caloric requirements and the risk of aspiration after surgery was not significant (p = 0.097). There was no statistically or clinically significant difference in speech, swallowing ability, swallowing safety and QOL outcomes between p16-positive and negative OPSCC. Conclusions Surgically treated OPSCC patients demonstrate excellent swallowing function and can achieve excellent speech perception. P16 status may not be predictive of functional outcomes or QOL in surgically treated OPSCC.
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Affiliation(s)
- Hani Z Marzouki
- Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Vincent L Biron
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Peter T Dziegielewski
- Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Otolaryngology, University of Florida, Florida, USA
| | - Andrew Ma
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Jason Vaz
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Gabriela Constantinescu
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Jeffrey Harris
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Daniel O'Connell
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
| | - Hadi Seikaly
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta and Alberta Health Services, 1E4.34, WMC 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada
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12
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Iriya PMDO, Romaniszen LW, Fernandes TMF, Poleti ML. Health-related quality of life of patients with squamous cell carcinoma: a comparison according to tumor location. Braz Oral Res 2017; 31:e105. [PMID: 29267666 DOI: 10.1590/1807-3107bor-2017.vol31.0105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 11/10/2017] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the health-related quality of life (QOL) of patients with squamous cell carcinoma (SCC) according to tumor location. The sample consisted of 27 patients with primary SCC in the oral cavity (n = 15), pharynx (n = 7), and larynx (n = 5) who were undergoing cancer treatment at the Cancer Hospital of Londrina, regardless of age, sex, clinical stage, and type of antineoplastic treatment. Health-related QOL was evaluated using the 30-item Cancer-Quality of Life Questionnaire (QLQ-C30), the 35-item Head and Neck Cancer-Quality of Life Questionnaire (QLQ-HN35), and the University of Washington Quality of Life Questionnaire (UW-QOL). These questionnaires were administered individually to each patient before ambulatory care. Sociodemographic data (age and sex) and clinical data (T stage, tumor location, and type of antineoplastic treatment) were collected from the patients' medical records. Scores were compared according to tumor location using the chi-squared test and one-way analysis of variance (p < 0.05). No score differed significantly according to tumor location. It can be concluded that the health-related QOL of patients with SCC was not influenced by tumor location.
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13
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Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures. Eur Arch Otorhinolaryngol 2017; 274:2695-2707. [PMID: 28343337 PMCID: PMC5486547 DOI: 10.1007/s00405-017-4519-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 02/21/2017] [Indexed: 11/12/2022]
Abstract
The aim of this review was to compare systematically the subjective measure of trismus between different interventions to treat head and neck cancer, particularly those of the oropharynx. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines, Six databases were searched for the text using various terms which include “oropharyngeal/head and neck cancer”, “trismus/mouth opening” and the various treatment modalities. Included in the review were clinical studies (> or =10 patients). Three observers independently assessed the papers identified. Among the six studies reviewed, five showed a significantly worst outcome with regard to the quality-of-life questionnaire scores for a radiotherapy or surgery and radiotherapy (RT) ± chemotherapy or chemoradiotherapy when compared to surgery alone. Only one study showed no significant difference between surgery alone and other treatment modalities. Subjective quality-of-life measures are a concurrent part of modern surgical practice. Although subjective measures were utilised to measure post operative trismus successfully, there was no consensus as to which treatment modality had overall better outcomes, with conflicting studies in keeping with the current debate in this field. Larger and higher quality studies are needed to compare all three treatment modalities.
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14
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Dietz A, Wichmann G, Wiegand S. Should We De-escalate the Treatment for HPV-Positive Tumors? Recent Results Cancer Res 2017; 206:173-181. [PMID: 27699538 DOI: 10.1007/978-3-319-43580-0_13] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
De-escalation or de-intensification of therapy is discussed since many retrospective analyses of former trials demonstrated significantly better outcome for patients suffering from p16/HPV16-positive oropharyngeal squamous cell carcinoma of head and neck (OHNSCC). These observations are comprehensively addressed, but the reader has to keep in mind that none of the currently discussed data result from prospective controlled trials addressing the HPV-discrimination in the primary endpoint design. Identification of the true HPV16-related tumors is still challenging and in addition with different clinical reports and lack of data of prospective trials not mature for routine clinical decision making in 2016. Independent of the currently lacking evidence for HPV-dependent treatment de-escalation, there are some relevant arguments to address this question in ongoing and future trials.
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Affiliation(s)
- Andreas Dietz
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Department Kopf- und Zahnmedizin, Universitätsklinikum Leipzig, Leipzig, Germany.
- Clinic of Otolaryngology, Head and Neck Surgery, Department of Head Medicine and Oral Health, University of Leipzig, Leipzig, Germany.
| | - Gunnar Wichmann
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Department Kopf- und Zahnmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
- Clinic of Otolaryngology, Head and Neck Surgery, Department of Head Medicine and Oral Health, University of Leipzig, Leipzig, Germany
| | - Susanne Wiegand
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Department Kopf- und Zahnmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
- Clinic of Otolaryngology, Head and Neck Surgery, Department of Head Medicine and Oral Health, University of Leipzig, Leipzig, Germany
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Structured review of papers reporting specific functions in patients with cancer of the head and neck: 2006 - 2013. Br J Oral Maxillofac Surg 2016; 54:e45-51. [PMID: 26923873 DOI: 10.1016/j.bjoms.2016.02.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 02/09/2016] [Indexed: 11/21/2022]
Abstract
Health-related quality of life (HRQoL) focuses on 4 core domains: physical and psychological function, social interaction, disease, and treatment-related symptoms, and is a key outcome in patients with cancer of the head and neck. We reviewed papers published between 2006 and 2013 that used validated questionnaires to report functional outcome in this group. A total of 572 papers were identified and 118 of them concerned function. Specific outcomes included anxiety, chewing, maxillectomy, mucositis, pain, shoulder function, and trismus. The specific functions most often identified were xerostomia, speech or voice, and swallowing or dysphagia. A considerable body of evidence has now accumulated on HRQoL and functional outomes although the precise role of HRQoL during the planning of treatment remains controversial. Over time, the emphasis of the studies included has tended to move away from the reporting of outcomes in general to more hypothesis-driven and group-specific work.
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Togna GDRD, Michel-Crosato E, Di Nubila HBV, Crosato E. Perspectivas de utilização da CIF em saúde bucal do trabalhador. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2015. [DOI: 10.1590/0303-7657000087813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Resumo Para a estruturação de um sistema de informação em saúde, é importante o fornecimento de um esquema de codificação. A utilização da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) permite a descrição da saúde e dos estados relacionados à saúde, avaliando o que é significativo para o indivíduo e complementando a informação sobre o diagnóstico fornecida pela Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde – CID. Este ensaio explora a estrutura e o modelo conceitual da CIF, indicando as perspectivas de utilização da CIF em saúde bucal do trabalhador. A avaliação do impacto de uma condição de saúde bucal é fundamental para o planejamento de ações que considerem a integralidade da saúde, bem como sua relação com o bem-estar e a qualidade de vida no trabalho. A CIF é a ferramenta imprescindível para a viabilização de uma abordagem abrangente capaz de abarcar as múltiplas dimensões envolvidas em uma situação de comprometimento da saúde bucal, qualificando as informações disponíveis para a definição de estratégias de intervenção em saúde do trabalhador.
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Early stage oropharyngeal carcinomas: comparing quality of life for different treatment modalities. BIOMED RESEARCH INTERNATIONAL 2014; 2014:421964. [PMID: 24719863 PMCID: PMC3955642 DOI: 10.1155/2014/421964] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 01/08/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To compare long-term quality of life outcomes after treating early stage oropharyngeal carcinoma either with surgery, surgery combined with radiotherapy, or surgery combined with chemoradiotherapy. METHODS Questionnaire based method: 111 eligible patients agreed to fill out a quality of life questionnaire. RESULTS Of the 32 scales contained in the EORTC's combined QLQ-C30 and HN35, 11 scales show significantly better results for the surgery-only treatment group when compared to either surgery combined with radiotherapy or surgery combined with any type of adjuvant therapy. These eleven scales are role function (P = 0.019/0.008), social function (P = 0.01/0.034), nausea (P = 0.017/0.025), pain (P = 0.014/0.023), financial problems (P = 0.030/0.012), speech (P = 0.02/0.015), social eating (P = 0.003/<0.001), mouth opening (P = 0.033/0.016), sticky saliva (P = 0.001/<0.001), swallowing (P < 0.001/<0.001), and dry mouth (P < 0.001/0.001). CONCLUSION Treatment of early stage oropharyngeal carcinoma with surgery alone has definite advantages over treatments including any form of adjuvant therapy when considering quality of life. Advantages manifest themselves especially in functional aspects of the head and neck realm; however general health aspects as well as psychosocial aspects show improvements as well. This study does not show any indication of QOL-related drawbacks of surgery-only treatment approaches.
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Crombie AK, Farah CS, Batstone MD. Health-related quality of life of patients treated with primary chemoradiotherapy for oral cavity squamous cell carcinoma: a comparison with surgery. Br J Oral Maxillofac Surg 2013; 52:111-7. [PMID: 24148700 DOI: 10.1016/j.bjoms.2013.09.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 09/21/2013] [Indexed: 11/29/2022]
Abstract
Our aim was to document the health-related quality of life (QoL) of patients with squamous cell carcinoma (SCC) of the oral cavity who were treated with chemoradiotherapy, and to compare it with that of patients treated with conventional surgery with or without adjuvant treatment. All patients who presented with SCC of the oral cavity treated with chemoradiotherapy alone at the Royal Brisbane & Women's Hospital between 2000 and 2011 and who were alive without disease were included. Health-related QoL was assessed by the University of Washington QoL questionnaire version 4, and the European Organisation for the Research and Treatment of Cancer (EORTC) QoL questionnaires C30 and HN35. The questionnaires were sent to all survivors. Those who responded to chemoradiotherapy were matched with patients who were treated by conventional surgery with or without adjuvant treatment by age, sex, subsite of tumour, and TNM stage. Sixteen patients completed the questionnaires (8 in each group). There was no significant difference between the 2 groups in any of the domains of any of the questionnaires. The overall outcome scores for both treatments in all 3 groups were reasonably high, which suggests that both treatments provided acceptable health-related QoL. The surgical group recorded higher scores than the chemoradiotherapy alone group in all domains of the UW-QoL except shoulder and anxiety. They recorded lower scores in all scales and items of EORTC HN35. There was no significant difference in health-related QoL between the 2 groups. Conventional surgery with or without adjuvant treatment recorded higher scores in most QoL domains including chewing, swallowing, saliva, and speech, issues most important to patients with SCC of the oral cavity.
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Affiliation(s)
- Anthony K Crombie
- Maxillofacial Unit, Royal Brisbane & Women's Hospital, Herston, Qld 4029, Australia; The University of Queensland, School of Dentistry, Brisbane, Qld 4000, Australia; The University of Queensland Centre for Clinical Research, Herston, Qld 4006, Australia.
| | - Camile S Farah
- The University of Queensland, School of Dentistry, Brisbane, Qld 4000, Australia; The University of Queensland Centre for Clinical Research, Herston, Qld 4006, Australia
| | - Martin D Batstone
- Maxillofacial Unit, Royal Brisbane & Women's Hospital, Herston, Qld 4029, Australia; The University of Queensland Centre for Clinical Research, Herston, Qld 4006, Australia
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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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Bücheler B, Ehnes A, Kavsadze M, Langenberg S, Wilhelm-Buchstab T, Zipfel M, Keiner S, Gerstner A. Lebensqualität nach Therapie von Kopf-Hals-Tumoren. HNO 2012. [DOI: 10.1007/s00106-012-2628-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Functional outcome after different oncological interventions in head and neck cancer patients. J Cancer Res Clin Oncol 2011; 138:371-6. [DOI: 10.1007/s00432-011-1106-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 11/21/2011] [Indexed: 10/15/2022]
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