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Taylor KJ, Amdal CD, Bjordal K, Astrup GL, Herlofson BB, Duprez F, Gama RR, Jacinto A, Hammerlid E, Scricciolo M, Jansen F, Verdonck-de Leeuw IM, Fanetti G, Guntinas-Lichius O, Inhestern J, Dragan T, Fabian A, Boehm A, Wöhner U, Kiyota N, Krüger M, Bonomo P, Pinto M, Nuyts S, Silva JC, Stromberger C, Specenier P, Tramacere F, Bushnak A, Perotti P, Plath M, Paderno A, Stempler N, Kouri M, Grégoire V, Singer S. Long-term health-related quality of life in head and neck cancer survivors: A large multinational study. Int J Cancer 2024; 154:1772-1785. [PMID: 38312044 DOI: 10.1002/ijc.34861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 02/06/2024]
Abstract
Head and neck cancer (HNC) patients suffer from a range of health-related quality of life (HRQoL) issues, but little is known about their long-term HRQoL. This study explored associations between treatment group and HRQoL at least 5 years' post-diagnosis in HNC survivors. In an international cross-sectional study, HNC survivors completed the European Organization for Research and Treatment of Cancer (EORTC) quality of life core questionnaire (EORTC-QLQ-C30) and its HNC module (EORTC-QLQ-H&N35). Meaningful HRQoL differences were examined between five treatment groups: (a) surgery, (b) radiotherapy, (c) chemo-radiotherapy, (d) radiotherapy ± chemotherapy and neck dissection and (e) any other surgery (meaning any tumour surgery that is not a neck dissection) and radiotherapy ± chemotherapy. Twenty-six sites in 11 countries enrolled 1105 survivors. They had a median time since diagnosis of 8 years, a mean age of 66 years and 71% were male. After adjusting for age, sex, tumour site and UICC stage, there was evidence for meaningful differences (10 points or more) in HRQoL between treatment groups in seven domains (Fatigue, Mouth Pain, Swallowing, Senses, Opening Mouth, Dry Mouth and Sticky Saliva). Survivors who had single-modality treatment had better or equal HRQoL in every domain compared to survivors with multimodal treatment, with the largest differences for Dry Mouth and Sticky Saliva. For Global Quality of Life, Physical and Social Functioning, Constipation, Dyspnoea and Financial Difficulties, at least some treatment groups had better outcomes compared to a general population. Our data suggest that multimodal treatment is associated with worse HRQoL in the long-term compared to single modality.
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Affiliation(s)
- Katherine J Taylor
- Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre Mainz, Mainz, Germany
| | - Cecilie D Amdal
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- Research Support Service, Oslo University Hospital, Oslo, Norway
| | - Kristin Bjordal
- Research Support Service, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Guro L Astrup
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Bente B Herlofson
- University of Oslo, Faculty of Dentistry, Oslo, Norway
- Department of Otorhinolaryngology, Oslo University Hospital, Oslo, Norway
| | - Fréderic Duprez
- Department of Radiotherapy-Oncology, Ghent University Hospital, Faculty of Medicine and Health Sciences-Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Ricardo R Gama
- Department of Head and Neck Surgery, Barretos Cancer Hospital, Barretos, Brazil
| | - Alexandre Jacinto
- Department of Radiation Oncology, Barretos Cancer Hospital, Barretos, Brazil
| | - Eva Hammerlid
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Femke Jansen
- Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Giuseppe Fanetti
- Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | | | - Johanna Inhestern
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
- Department of Otorhinolaryngology, Oberhavelkliniken Hennigsdorf, Hennigsdorf, Germany
| | - Tatiana Dragan
- Department of Radiation Oncology, Head and Neck Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Alexander Fabian
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Andreas Boehm
- Department of Otorhinolaryngology, St. Georg Hospital, Leipzig, Germany
| | - Ulrike Wöhner
- Department of Otorhinolaryngology, St. Georg Hospital, Leipzig, Germany
| | - Naomi Kiyota
- Cancer Center, Kobe University Hospital, Kobe, Japan
| | - Maximilian Krüger
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Centre Mainz, Mainz, Germany
| | - Pierluigi Bonomo
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Monica Pinto
- Rehabilitation Medicine Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Sandra Nuyts
- Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, Leuven, Belgium
- Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Joaquim Castro Silva
- Department of Otolaryngology, Head and Neck Surgery, Instituto Português de Oncologia Francisco Gentil Do Porto, Porto, Portugal
| | - Carmen Stromberger
- Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Pol Specenier
- Department of Oncology, Antwerp University Hospital, Edegem, Belgium
| | | | - Ayman Bushnak
- Department of Otorhinolaryngology, University Hospital Gießen und Marburg, Giessen, Germany
| | - Pietro Perotti
- Department of Otorhinolaryngology - Head and Neck Surgery, "S. Chiara" Hospital, Azienda Provinciale Per I Servizi Sanitari (APSS), Trento, Italy
| | - Michaela Plath
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Alberto Paderno
- Department of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Noa Stempler
- Oral Medicine Unit, Sheba Medical Center, Tel Hashomer, Israel
| | - Maria Kouri
- Dental Oncology Unit, Department of Oral Medicine and Pathology and Hospital Dentistry, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vincent Grégoire
- Department of Radiation Oncology, Centre Leon Berard, Lyon, France
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre Mainz, Mainz, Germany
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Singer S, Sykiotis G, Al-Ibraheem A, Pinto M, Iakovou I, Østhus AA, Hammerlid E, Locati LD, Gamper EM, Arraras JI, Jordan S, Buettner M, Engesser D, Taylor K, Canotilho R, Ioannidis G, Husson O, Gama RR, Fanetti G, Moss L, Inhestern J, Andry G, Rimmele H, Kiyota N. The impact of electronic versus paper-based data capture on data collection logistics and on missing scores in thyroid cancer patients. Endocrine 2023:10.1007/s12020-023-03628-9. [PMID: 38103143 DOI: 10.1007/s12020-023-03628-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/23/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE The purpose of this study was to investigate the impact of the type of data capture on the time and help needed for collecting patient-reported outcomes as well as on the proportion of missing scores. METHODS In a multinational prospective study, thyroid cancer patients from 17 countries completed a validated questionnaire measuring quality of life. Electronic data capture was compared to the paper-based approach using multivariate logistic regression. RESULTS A total of 437 patients were included, of whom 13% used electronic data capture. The relation between data capture and time needed was modified by the emotional functioning of the patients. Those with clinical impairments in that respect needed more time to complete the questionnaire when they used electronic data capture compared to paper and pencil (ORadj 24.0; p = 0.006). This was not the case when patients had sub-threshold emotional problems (ORadj 1.9; p = 0.48). The odds of having the researcher reading the questions out (instead of the patient doing this themselves) (ORadj 0.1; p = 0.01) and of needing any help (ORadj 0.1; p = 0.01) were lower when electronic data capture was used. The proportion of missing scores was equivalent in both groups (ORadj 0.4, p = 0.42). CONCLUSIONS The advantages of electronic data capture, such as real-time assessment and fewer data entry errors, may come at the price of more time required for data collection when the patients have mental health problems. As this is not uncommon in thyroid cancer, researchers need to choose the type of data capture wisely for their particular research question.
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Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany.
- University Cancer Centre, Mainz, Germany.
| | - Gerasimos Sykiotis
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Monica Pinto
- Rehabilitation Medicine Unit, Strategic Health Services Department, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Ioannis Iakovou
- Department of Nuclear Medicine, Aristotle University, Thessaloniki, Greece
| | - Arild Andre Østhus
- ENT and Head and Neck Department, University Medical Centre Oslo, Oslo, Norway
| | - Eva Hammerlid
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Laura Deborah Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS istituto Nazionale dei Tumori, Milan, Italy
| | - Eva Maria Gamper
- Department of Nuclear Medicine and Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Susan Jordan
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Matthias Buettner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Deborah Engesser
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Katherine Taylor
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Rita Canotilho
- Instituto Português do Oncologia do Porto Francisco Gentil, Porto, Portugal
| | | | - Olga Husson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Giuseppe Fanetti
- Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, PN, Italy
| | - Laura Moss
- Velindre Cancer Centre, Velindre University NHS Trust, Cardiff, UK
| | - Johanna Inhestern
- Department of Otorhinolaryngology, Oberhavelkliniken, Hennigsdorf, Germany
| | - Guy Andry
- Surgery Department, Jules Bordet Institute, Brussels, Belgium
| | - Harald Rimmele
- Bundesverband Schilddrüsenkrebs - Ohne Schilddrüse leben e. V., Berlin, Germany
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan
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Singer S, Al-Ibraheem A, Pinto M, Iakovou I, Østhus AA, Hammerlid E, Locati LD, Gamper E, Ignacio J, Jordan SJ, Kiyota N, Buettner M, Engesser D, Canotilho R, Ioannidis G, Husson O, Gama RR, Fanetti G, Moss L, Inhestern J, Andry G, Fuehrer D, Kuliś D, Rimmele H, Sykiotis G. International Phase IV Field Study for the Reliability and Validity of the European Organisation for Research and Treatment of Cancer Thyroid Cancer Module EORTC QLQ-THY34. Thyroid 2023; 33:1078-1089. [PMID: 37450344 DOI: 10.1089/thy.2023.0221] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Purpose: The aim of this study was to validate the new European Organisation for Research and Treatment of Cancer Quality of Life Thyroid Cancer Module (EORTC QLQ-THY34). Methods: We enrolled 437 thyroid cancer patients from 17 countries. One group (n = 303), undergoing treatment or best supportive care, completed the questionnaires at three time points (before therapy [t1], 6 weeks later [t2], and 6 months after t2 [t3]). A second group (survivors ≥2 years after diagnosis, n = 134) completed it at a random baseline time point and a second time 1 week later. We determined internal consistency (using Cronbach's alpha), the scale structure (with confirmatory factor analysis), and discriminant validity (using known-group comparisons). Group 1 data were used to assess responsiveness and group 2 data to determine test-retest reliability using intra-class correlations (ICC). Results: All 34 items fulfilled the criteria to be kept in the questionnaire. Cronbach's alpha was >0.70 in 8 of the 9 multi-item scales. All standardized factor loadings exceeded 0.40, confirming the proposed scale structure. The ICC was >0.70 in all scales expressing good test-retest reliability. Differences in scale scores between patients with different histology were >5 points in all scales. In all but one of the pre-specified scales (Dry Mouth), changes over time were ≥|4| points between at least two time points. Conclusion: The EORTC QLQ-THY34 with its 9 multi-item and 8 single-item scales is a reliable and valid tool to measure quality of life in thyroid cancer patients and can be used in future trials and studies.
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Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
- University Cancer Centre, Mainz, Germany
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Monica Pinto
- Rehabilitation Medicine Unit, Strategic Health Services Department, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Ioannis Iakovou
- Department of Nuclear Medicine, Aristotle University, Thessaloniki, Greece
| | - Arild Andre Østhus
- ENT and Head and Neck Department, University Medical Centre Oslo, Oslo, Norway
| | - Eva Hammerlid
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Laura Deborah Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Eva Gamper
- Department of Nuclear Medicine and Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital Psychiatry II, Medical University of Innsbruck, Austria
| | - Juan Ignacio
- Oncology Departments, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Susan J Jordan
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan
| | - Matthias Buettner
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Deborah Engesser
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Rita Canotilho
- Instituto Português do Oncologia do Porto Francisco Gentil, Porto, Portugal
| | | | - Olga Husson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Giuseppe Fanetti
- Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
| | - Laura Moss
- Velindre Cancer Centre, Velindre University NHS Trust, Cardiff, United Kingdom
| | - Johanna Inhestern
- Department of Otorhinolaryngology, Oberhavelkliniken, Hennigsdorf, Germany
| | - Guy Andry
- Surgery Department, Jules Bordet Institute, Brussels, Belgium
| | - Dagmar Fuehrer
- Department of Endocrinology, Diabetes and Metabolism, Endocrine Tumour Center at WTZ, Member of ENDO-ERN and EURACAN, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dagmara Kuliś
- European Organisation for Research and Treatment of Cancer (EORTC), Quality of Life Department, Brussels, Belgium
| | - Harald Rimmele
- Bundesverband Schilddrüsenkrebs-Ohne Schilddrüse leben e. V., Berlin, Germany
| | - Gerasimos Sykiotis
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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4
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Taylor KJ, Amdal CD, Bjordal K, Astrup GL, Herlofson BB, Duprez F, Gama RR, Jacinto A, Hammerlid E, Scricciolo M, Jansen F, Verdonck-de Leeuw IM, Fanetti G, Guntinas-Lichius O, Inhestern J, Dragan T, Fabian A, Boehm A, Wöhner U, Kiyota N, Krüger M, Bonomo P, Pinto M, Nuyts S, Silva JC, Stromberger C, Tramacere F, Bushnak A, Perotti P, Plath M, Paderno A, Stempler N, Kouri M, Singer S. Serious Long-Term Effects of Head and Neck Cancer from the Survivors' Point of View. Healthcare (Basel) 2023; 11:healthcare11060906. [PMID: 36981562 PMCID: PMC10048748 DOI: 10.3390/healthcare11060906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 03/30/2023] Open
Abstract
The long-term problems of head and neck cancer survivors (HNCS) are not well known. In a cross-sectional international study aimed at exploring the long-term quality of life in this population, 1114 HNCS were asked to state their two most serious long-term effects. A clinician recorded the responses during face-to-face appointments. A list of 15 example problems was provided, but a free text field was also available. A total of 1033 survivors responded to the question. The most frequent problems were 'dry mouth' (DM) (n = 476; 46%), 'difficulty swallowing/eating' (DSE) (n = 408; 40%), 'hoarseness/difficulty speaking' (HDS) (n = 169; 16%), and 'pain in the head and neck' (PHN) (n = 142; 14%). A total of 5% reported no problems. Logistic regression adjusted for age, gender, treatment, and tumor stage and site showed increased odds of reporting DM and DSE for chemo-radiotherapy (CRT) alone compared to surgery alone (odds ratio (OR): 4.7, 95% confidence interval (CI): 2.5-9.0; OR: 2.1, CI: 1.1-3.9), but decreased odds for HDS and PHN (OR: 0.3, CI: 0.1-0.6; OR: 0.2, CI: 0.1-0.5). Survivors with UICC stage IV at diagnosis compared to stage I had increased odds of reporting HDS (OR: 1.9, CI: 1.2-3.0). Laryngeal cancer survivors had reduced odds compared to oropharynx cancer survivors of reporting DM (OR: 0.4, CI: 0.3-0.6) but increased odds of HDS (OR: 7.2, CI: 4.3-12.3). This study provides evidence of the serious long-term problems among HNCS.
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Affiliation(s)
- Katherine J Taylor
- Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre Mainz, 55131 Mainz, Germany
| | - Cecilie D Amdal
- Department of Oncology, Oslo University Hospital, 0372 Oslo, Norway
- Research Support Service, Oslo University Hospital 0372 Oslo, Norway
| | - Kristin Bjordal
- Research Support Service, Oslo University Hospital 0372 Oslo, Norway
- Faculty of Medicine, University of Oslo, 0372 Oslo, Norway
| | - Guro L Astrup
- Department of Oncology, Oslo University Hospital, 0372 Oslo, Norway
| | - Bente B Herlofson
- Faculty of Dentistry, University of Oslo, 0455 Oslo, Norway
- Department of Otorhinolaryngology, Oslo University Hospital, 0372 Oslo, Norway
| | - Fréderic Duprez
- Department of Radiotherapy-Oncology, Faculty of Medicine and Health Sciences-Human Structure and Repair, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Ricardo R Gama
- Department of Head and Neck Surgery, Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil
| | - Alexandre Jacinto
- Department of Radiation Oncology, Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil
| | - Eva Hammerlid
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Melissa Scricciolo
- Department of Radiation Oncology, Ospedale dell'Angelo, 30174 Venice, Italy
| | - Femke Jansen
- Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC Location Vrije Universiteit, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, 1081 HV Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC Location Vrije Universiteit, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, 1081 HV Amsterdam, The Netherlands
- Department Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, 1081 HV Amsterdam, The Netherlands
| | - Giuseppe Fanetti
- Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy
| | | | - Johanna Inhestern
- Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany
- Department of Otorhinolaryngology, Oberhavelkliniken Hennigsdorf, 16761 Hennigsdorf, Germany
| | - Tatiana Dragan
- Head and Neck Unit, Department of Radiation Oncology, Institut Jules Bordet, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Alexander Fabian
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, 24105 Kiel, Germany
| | - Andreas Boehm
- Department of Otorhinolaryngology, St. Georg Hospital, 04129 Leipzig, Germany
| | - Ulrike Wöhner
- Department of Otorhinolaryngology, St. Georg Hospital, 04129 Leipzig, Germany
| | - Naomi Kiyota
- Cancer Center, Kobe University Hospital, Kobe 650-0017, Japan
| | - Maximilian Krüger
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Centre Mainz, 55131 Mainz, Germany
| | - Pierluigi Bonomo
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Monica Pinto
- Rehabilitation Medicine Unit, Strategic Health Services Department, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy
| | - Sandra Nuyts
- Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Joaquim C Silva
- Department of Otolaryngology, Head and Neck Surgery, Instituto Português de Oncologia Francisco Gentil do Porto, 4200-072 Porto, Portugal
| | - Carmen Stromberger
- Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany
- Berlin Institute of Health, 10178 Berlin, Germany
| | - Francesco Tramacere
- Department of Radiation Oncology, Azienda Sanitaria Locale, 72100 Brindisi, Italy
| | - Ayman Bushnak
- Department of Otorhinolaryngology, University Hospital Gießen und Marburg, 35392 Giessen, Germany
| | - Pietro Perotti
- Department of Otorhinolaryngology-Head and Neck Surgery, "S. Chiara" Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), 38122 Trento, Italy
| | - Michaela Plath
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Alberto Paderno
- Department of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy
| | - Noa Stempler
- Oral Medicine Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 5262000, Israel
| | - Maria Kouri
- Dental Oncology Unit, Department of Oral Medicine and Pathology and Hospital Dentistry, Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre Mainz, 55131 Mainz, Germany
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5
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Büttner M, Locati LD, Pinto M, Araújo C, Tomaszewska IM, Kiyota N, Vidhubala E, Brannan C, Hammerlid E, Husson O, Salem D, Ioannidis G, Gamper E, Arraras JI, Andry G, Inhestern J, Theurer J, Taylor K, Singer S. Quality of Life in Patients With Hypoparathyroidism After Treatment for Thyroid Cancer. J Clin Endocrinol Metab 2020; 105:5904489. [PMID: 32918085 DOI: 10.1210/clinem/dgaa597] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/09/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Surgical complications such as hypoparathyroidism (HPT) or vocal cord palsy are seldom assessed when the quality of life (QOL) in thyroid cancer patients is investigated. The aim of this study was to measure the QOL difference in thyroid cancer survivors with and without HPT. METHODS Participants for this analysis were enrolled in 13 countries from a study that pilot-tested a thyroid cancer-specific QOL instrument. They were included if they had been diagnosed with thyroid cancer at least 9 months previously. QOL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC QLQ-C30) and some items on HPT symptoms (eg, tingling in fingers or toes). HPT status and other clinical data were extracted from the patients' medical charts. Comparisons of QOL domains between patients with and without HPT were performed using Mann-Whitney U test. The occurrence of HPT-related symptoms was compared using chi-square tests. Multiple ordinal regression analysis was performed to evaluate factors that might affect QOL. RESULTS Eighty-nine patients participated in this study, 17 of whom were considered to have HPT. Patients in the HPT group reported significantly reduced QOL in 9 of the 15 scales of the EORTC QLQ-C30 compared to patients without HPT. Regression analysis showed that HPT was independently negatively associated with various scales of the QLQ-C30. Both groups showed a high prevalence of typical HPT symptoms. CONCLUSION Thyroid cancer patients with HPT report significantly impaired QOL compared to thyroid cancer survivors without HPT. The assessment of HPT should be considered when measuring QOL in thyroid cancer patients.
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Affiliation(s)
- Matthias Büttner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
- University Cancer Centre, Mainz, Germany
| | - Laura D Locati
- Head & Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Monica Pinto
- Rehabilitation Medicine Unit, Strategic Health Services Department, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Cláudia Araújo
- Service of Surgical Oncology, Instituto Português do Oncologia do Porto Francisco Gentil, Porto, Portugal
| | - Iwona M Tomaszewska
- Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan
| | - E Vidhubala
- Nellai Cancer Care Center, Tirunelveli, Tamil Nadu, India
| | - Christine Brannan
- Mount Vernon Cancer Centre, East & North Herts NHS Trust, Northwood, London, UK
| | - Eva Hammerlid
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Olga Husson
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Dina Salem
- Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Eva Gamper
- Department of Nuclear Medicine, Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Psychiatry II Medical University of Innsbruck, Innsbruck, Austria
| | | | - Guy Andry
- Surgery Department, Jules Bordet Institute, Brussels, Belgium
| | - Johanna Inhestern
- Clinic of Otorhinolaryngology, Oberhavel Kliniken, Hennigsdorf, Germany
| | - Juliane Theurer
- Department of Surgery, University Medical Center Mainz, Mainz, Germany
| | - Katherine Taylor
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
- University Cancer Centre, Mainz, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
- University Cancer Centre, Mainz, Germany
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6
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Singer S, Amdal CD, Hammerlid E, Tomaszewska IM, Castro Silva J, Mehanna H, Santos M, Inhestern J, Brannan C, Yarom N, Fullerton A, Pinto M, Arraras JI, Kiyota N, Bonomo P, Sherman AC, Baumann I, Galalae R, Fernandez Gonzalez L, Nicolatou-Galitis O, Abdel-Hafeez Z, Raber-Durlacher J, Schmalz C, Zotti P, Boehm A, Hofmeister D, Krejovic Trivic S, Loo S, Chie WC, Bjordal K, Brokstad Herlofson B, Grégoire V, Licitra L. International validation of the revised European Organisation for Research and Treatment of Cancer Head and Neck Cancer Module, the EORTC QLQ-HN43: Phase IV. Head Neck 2019; 41:1725-1737. [PMID: 30636188 DOI: 10.1002/hed.25609] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 10/25/2018] [Accepted: 12/10/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND We validated the new European Organisation for Research and Treatment of Cancer Quality of Life Head and Neck Module (EORTC QLQ-HN43). METHODS We enrolled 812 patients with head and neck cancer from 18 countries. Group 1 completed the questionnaire before therapy, and 3 and 6 months later. In group 2 (survivors), we determined test-retest reliability using intraclass correlation coefficients (ICC). Internal consistency was assessed using Cronbach's Alpha, the scale structure with confirmatory factor analysis, and discriminant validity with known-group comparisons. RESULTS Cronbach's alpha was >0.70 in 10 of the 12 multi-item scales. All standardized factor loadings exceeded 0.40. The ICC was >0.70 in all but two scales. Differences in scale scores between known-groups were >10 points in 17 of the 19 scales. Sensitivity to change was found to be sufficient in 18 scales. CONCLUSIONS Evidence supports the reliability and validity of the EORTC QLQ-HN43 as a measure of quality of life.
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Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | | | - Eva Hammerlid
- Department of Otolaryngology and Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden
| | - Iwona M Tomaszewska
- Department of Medical Didactics, Jagiellonian University Medical College, Krakow, Poland
| | - Joaquim Castro Silva
- Department of Otolaryngology, Head and Neck Surgery, Instituto Português de Oncologia Francisco Gentil do Porto, Porto, Portugal
| | - Hisham Mehanna
- Institute of Head and Neck Studies and Education, University of Birmingham, Birmingham, United Kingdom
| | - Marcos Santos
- Radiation Oncology Department, Brasilia University Hospital, Brasilia, Brazil
| | - Johanna Inhestern
- Clinic of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Christine Brannan
- Lynda Jackson Macmillan Centre, East & North Hertfordshire NHS Trust incorporating Mount Vernon Cancer Centre, Northwood, United Kingdom
| | - Noam Yarom
- Oral Medicine Unit, Sheba Medical Center, Tel-Hashomer, Israel and School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amy Fullerton
- Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Monica Pinto
- Supportive Care Department, Istituto Nazionale Tumori -IRCCS- Fondazione G. Pascale, Naples, Italy
| | - Juan I Arraras
- Oncology Departments, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Kobe University Hospital Cancer Center, Kobe, Japan
| | - Pierluigi Bonomo
- Radiation Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Allen C Sherman
- Behavioral Medicine Division, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Ingo Baumann
- Department of Otolaryngology, Head and Neck Surgery, University of Heidelberg, Heidelberg, Germany
| | - Razvan Galalae
- Department of Radiation Oncology, EVK Gelsenkirchen, University Duisburg-Essen, Gelsenkirchen, Germany
| | | | - Ourania Nicolatou-Galitis
- Clinic of Hospital Dentistry, Dental Oncology Unit, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Judith Raber-Durlacher
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center (location AMC) and Department of Oral Medicine ACTA, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Claudia Schmalz
- Department of Radiation Therapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Paola Zotti
- Department of Psychology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Andreas Boehm
- Department of Otolaryngology Head and Neck Surgery, St. Georg Hospital, Leipzig, Germany
| | - Dirk Hofmeister
- Department of Medical Psychology, University Hospital Leipzig, Leipzig, Germany
| | - Sanja Krejovic Trivic
- Clinic of Otorhinolaryngology and Maxillofacial Surgery, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Suat Loo
- Department of Oncology, Colchester Hospital University NHS Foundation Trust, Colchester, United Kingdom
| | - Wei-Chu Chie
- Department of Family Medicine, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Kristin Bjordal
- Department of Research Support Services, Oslo University Hospital, and University of Oslo, Oslo, Norway
| | - Bente Brokstad Herlofson
- Department of Oral Surgery and Oral Medicine, University of Oslo, and Department of Otorhinolaryngology - Head and Neck Surgery Division for Head, Neck and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Vincent Grégoire
- Radiation Oncology Dept & Center for Molecular Imaging and Experimental Radiotherapy, Université Catholique de Louvain and St-Luc University Hospital, Brussels, Belgium
| | - Lisa Licitra
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, and University of Milan, Milan, Italy
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Inhestern J, Schmalenberg H, Dietz A, Rotter N, Maschmeyer G, Jungehülsing M, Grosse-Thie C, Kuhnt T, Görner M, Sudhoff H, Wittekindt C, Guntinas-Lichius O. A two-arm multicenter phase II trial of one cycle chemoselection split-dose docetaxel, cisplatin and 5-fluorouracil (TPF) induction chemotherapy before two cycles of split TPF followed by curative surgery combined with postoperative radiotherapy in patients with locally advanced oral and oropharyngeal squamous cell cancer (TISOC-1). Ann Oncol 2017; 28:1917-1922. [DOI: 10.1093/annonc/mdx202] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Singer S, Jordan S, Locati LD, Pinto M, Tomaszewska IM, Araújo C, Hammerlid E, Vidhubala E, Husson O, Kiyota N, Brannan C, Salem D, Gamper EM, Arraras JI, Ioannidis G, Andry G, Inhestern J, Grégoire V, Licitra L. The EORTC module for quality of life in patients with thyroid cancer: phase III. Endocr Relat Cancer 2017; 24:197-207. [PMID: 28223365 DOI: 10.1530/erc-16-0530] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 02/21/2017] [Indexed: 12/23/2022]
Abstract
The purpose of the study was to pilot-test a questionnaire measuring health-related quality of life (QoL) in thyroid cancer patients to be used with the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire EORTC QLQ-C30. A provisional questionnaire with 47 items was administered to patients treated for thyroid cancer within the last 2 years. Patients were interviewed about time and help needed to complete the questionnaire, and whether they found the items understandable, confusing or annoying. Items were kept in the questionnaire if they fulfilled pre-defined criteria: relevant to the patients, easy to understand, not confusing, few missing values, neither floor nor ceiling effects, and high variance. A total of 182 thyroid cancer patients in 15 countries participated (n = 115 with papillary, n = 31 with follicular, n = 22 with medullary, n = 6 with anaplastic, and n = 8 with other types of thyroid cancer). Sixty-six percent of the patients needed 15 min or less to complete the questionnaire. Of the 47 items, 31 fulfilled the predefined criteria and were kept unchanged, 14 were removed, and 2 were changed. Shoulder dysfunction was mentioned by 5 patients as missing and an item covering this issue was added. To conclude, the EORTC quality of life module for thyroid cancer (EORTC QLQ-THY34) is ready for the final validation phase IV.
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Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics Epidemiology and Informatics (IMBEI)University Medical Center Mainz, Mainz, Germany
- University Cancer CentreMainz, Germany
| | - Susan Jordan
- QIMR Berghofer Medical Research InstituteHerston, Australia
| | - Laura D Locati
- Head & Neck Medical Oncology UnitFondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Monica Pinto
- Rehabilitation UnitDepartment of Quality of Life, Istituto Nazionale per lo Studio e la Cura dei Tumori 'Fondazione Giovanni Pascale' - IRCCS, Naples, Italy
| | - Iwona M Tomaszewska
- Department of Medical EducationJagiellonian University Medical College, Krakow, Poland
| | - Cláudia Araújo
- Service of Surgical OncologyInstituto Português do Oncologia do Porto Francisco Gentil, Porto, Portugal
| | - Eva Hammerlid
- Department of Otolaryngology and Head and Neck SurgerySahlgrenska University Hospital, Gothenburg, Sweden
| | - E Vidhubala
- Department of Psycho-OncologyResource Centre for Tobacco Control, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | - Olga Husson
- Department of Medical PsychologyRadboud University Medical Center, Nijmegen, The Netherlands
| | - Naomi Kiyota
- Department of Medical Oncology and HematologyKobe University Hospital, Kobe, Japan
| | - Christine Brannan
- Mount Vernon Cancer CentreEast & North Herts NHS Trust, Northwood, London, UK
| | - Dina Salem
- Clinical OncologyFaculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eva M Gamper
- Department of Nuclear MedicineMedical University of Innsbruck, Innsbruck Institute of Patient-Centred Outcome Research, Innsbruck, Austria
| | | | | | - Guy Andry
- Surgery DepartmentJules Bordet Institute, Brussels, Belgium
| | - Johanna Inhestern
- Clinic of OtorhinolaryngologyJena University Hospital, Jena, Germany
| | - Vincent Grégoire
- Department of Radiation OncologyInstitut de Recherche Experimentale et Clinique, Université Catholique de Louvain, St-Luc University Hospital, Brussels, Belgium
| | - Lisa Licitra
- Head & Neck Medical Oncology UnitFondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Göllnitz I, Inhestern J, Wendt TG, Buentzel J, Esser D, Böger D, Mueller AH, Piesold JU, Schultze-Mosgau S, Eigendorff E, Schlattmann P, Guntinas-Lichius O. Role of comorbidity on outcome of head and neck cancer: a population-based study in Thuringia, Germany. Cancer Med 2016; 5:3260-3271. [PMID: 27726294 PMCID: PMC5119982 DOI: 10.1002/cam4.882] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 08/02/2016] [Indexed: 12/21/2022] Open
Abstract
To examine the impact of comorbidity on overall survival (OS) in a population‐based study of patients with head and neck cancer who were treated between 2009 and 2011. Data of 1094 patients with primary head and neck carcinomas without distant metastasis from the Thuringian cancer registries were evaluated concerning the influence of patient's characteristics and comorbidity on OS. Data on comorbidity prior to head and neck cancer diagnosis was adapted to the Charlson Comorbidity (CCI), age‐adjusted CCI (ACCI), head and neck CCI (HNCCI), simplified comorbidity score (SCS), and to the Adult Comorbidity Evaluation–27 (ACE‐27). Most patients were male (80%; median age: 60 years; 50% stage IV tumors). Smoking, alcohol abuse, and anemia were registered for 38%, 33%, and 23% of the patients, respectively. Predominant therapy was surgery + radiochemotherapy (30%), surgery (29%), and surgery + radiotherapy (21%). Mean CCI, ACCI, HNCCI, SCS and ACE‐27 were 1.0 ± 1.5, 2.6 ± 2.1, 0.6 ± 0.8, 4.4 ± 4.2, and 0.9 ± 0.9, respectively. Median follow‐up was 25.7 months. Multivariable analyses showed that higher age, higher UICC stage, no therapy, including surgery or radiotherapy, alcohol abuse, and anemia, higher comorbidity were independent risk factors for worse OS (all P < 0.05). According to the discriminatory power analysis none of the five comorbidity scores was superior to the other scores to prognosticate OS. This population‐based study showed that comorbidity is frequent in German patients with head and neck cancer and is an important risk factor for poor OS. Comorbidity should be routinely assessed and taken into account in prospective clinical trials.
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Affiliation(s)
- Irene Göllnitz
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Johanna Inhestern
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Thomas G Wendt
- Department of Radiooncology, Jena University Hospital, Jena, Germany
| | - Jens Buentzel
- Department of Otorhinolaryngology, Suedharzkrankenhaus Nordhausen, Nordhausen, Germany
| | - Dirk Esser
- Department of Otorhinolaryngology, Helios-Klinikum Erfurt, Erfurt, Germany
| | - Daniel Böger
- Department of Otorhinolaryngology, SRH Zentralklinikum Suhl, Suhl, Germany
| | - Andreas H Mueller
- Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany
| | - Jörn-Uwe Piesold
- Department of Oromaxillofacial Surgery, Helios-Klinikum Erfurt, Erfurt, Germany
| | - Stefan Schultze-Mosgau
- Department of Oromaxillofacial Surgery and Plastic Surgery, Jena University Hospital, Jena, Germany
| | | | - Peter Schlattmann
- Department of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany
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Geweiler J, Inhestern J, Berndt A, Guntinas-Lichius O. Parameters of Stromal Activation and Epithelial to Mesenchymal Transition as Predictive Biomarkers for Induction Chemotherapy in Patients With Locally Advanced Oral Cavity and Oropharyngeal Squamous Cell Cancer. Clin Exp Otorhinolaryngol 2016; 9:374-381. [PMID: 27416733 PMCID: PMC5115147 DOI: 10.21053/ceo.2015.01683] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/21/2016] [Accepted: 02/17/2016] [Indexed: 11/29/2022] Open
Abstract
Objectives Induction chemotherapy (IC) is likely to be effective for biologically distinct subgroups of oral cancer and biomarker development may lead to identification of those patients. Methods We evaluated immune cell infiltration, stroma formation and structure of the invasive front as well as the immunohistochemical expression of alpha smooth muscle actin (ASMA), CD163, E-cadherin, N-cadherin, and the laminin gamma 2 chain in pretreatment biopsy specimens and surgical resections after IC in 20 patients with locally advanced oral cancer who were treated in a prospective, ongoing, phase II trial on IC using docetaxel, cisplatin, and 5-fluorouracil (TPF). Results Significant negative prognostic factors for incomplete pathological tumor response to IC were alcohol abuse (P=0.032), cN+ (P=0.042), and <30% tumor reduction after first cycle of IC (P=0.034). Of the investigated histological parameters and biomarkers only a low membrane-bound expression of E-cadherin showed a trend to be associated with incomplete response to IC (P=0.061). Low expression of ASMA in stromal vessels and a strong tumor invasion front were significantly associated to tumor recurrence (P=0.024 and P=0.004, respectively). The median follow-up of all patients was 35 months. Alcohol abuse (P<0.001), <30% tumor reduction after first cycle of IC (P=0.005), and a strong tumor invasion front (P=0.019) were negative prognostic factors for overall survival. Conclusion A strong predictive biomarker among the investigated parameters for benefitting from TPF IC could not be found. The extent of the tumor invasion front was a negative prognostic marker for recurrence and survival in oral cancer treated by TPF IC followed by surgery and postoperative radiochemotherapy.
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Affiliation(s)
- Jana Geweiler
- Institute of Pathology, Jena University Hospital, Jena, Germany
| | - Johanna Inhestern
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
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Schiller U, Inhestern J, Burger U, Singer S, Guntinas-Lichius O. Predictors of post-treatment smoking and drinking behavior of head and neck cancer survivors: results of a population-based survey. Eur Arch Otorhinolaryngol 2016; 273:3337-45. [DOI: 10.1007/s00405-016-3924-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
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Ritter J, Inhestern J, Guntinas-Lichius O. [Ultrasound and electrocardiogram -assisted venous port implantation via the cephalic vein by head neck surgeons]. Laryngorhinootologie 2016; 95:82-4. [PMID: 26859729 DOI: 10.1055/s-0042-100957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Inhestern J, Oertel K, Stemmann V, Schmalenberg H, Dietz A, Rotter N, Veit J, Görner M, Sudhoff H, Junghanß C, Wittekindt C, Pachmann K, Guntinas-Lichius O. Prognostic Role of Circulating Tumor Cells during Induction Chemotherapy Followed by Curative Surgery Combined with Postoperative Radiotherapy in Patients with Locally Advanced Oral and Oropharyngeal Squamous Cell Cancer. PLoS One 2015; 10:e0132901. [PMID: 26186556 PMCID: PMC4505900 DOI: 10.1371/journal.pone.0132901] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 06/22/2015] [Indexed: 12/11/2022] Open
Abstract
Background The prognostic role of circulating tumor cells (CTCs) after induction chemotherapy using docetaxel, cisplatin and fluorouracil (TPF) prior to surgery and adjuvant (chemo)radiation in locally advanced oral squamous cell cancer (OSCC) was evaluated. Methods In this prospective study, peripheral blood samples from 40 patients of the phase II study TISOC-1 (NCT01108042) with OSCC before, during, and after treatment were taken. CTCs were quantified using laser scanning cytometry of anti– epithelial cell adhesion molecule–stained epithelial cells. Their detection was correlated with clinical risk factors, recurrence-free (RFS) and overall survival (OS). Results Before starting the treatment CTCs were detected in 32 of 40 patients (80%). The median number at baseline was 3295 CTCs/ml. The median maximal number of CTCs during treatment was 5005 CTCs/ml. There was a significant increase of CTCs before postoperative radiotherapy compared to baseline before 1st cycle of IC (p = 0.011), 2nd cycle of IC (p = 0.001), 3rd cycle of IC (p = 0.004), and before surgery (p = 0.002), but not compared to end of therapy (p = 0.118). CTCs at baseline >median was also associated to risk of recurrence (p = 0.014). Maximal CTCs during therapy >median was more frequently observed in tumors of the oral cavity (p=0.022) and related to higher risk of death during follow-up (p = 0.028). Patients with CTCs at baseline >median value had significant lower RFS than patients with CTCs at baseline <median value (p = 0.025). Patients with maximal CTCs values >median during the complete course of therapy had a significantly lower OS than patients with values <median (p = 0.049). Finally, the multivariate analysis revealed that OS was significantly lower in patients with maximal CTCs during treatment higher than the median value (HR=6.151; CI: 1.244-30.420). Conclusions Baseline CTCs and maximal CTCs during therapy both seem to be good prognostic markers for OSCC when treated by TPF induction chemotherapy, surgery, and postoperative (chemo)radiation.
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Affiliation(s)
- Johanna Inhestern
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Katrin Oertel
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Viola Stemmann
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | | | - Andreas Dietz
- Department of ENT Surgery, University Medical Center Leipzig, Leipzig, Germany
| | - Nicole Rotter
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Johannes Veit
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Martin Görner
- Department of Hematology and Oncology, Academic Teaching Hospital Bielefeld, Bielefeld, Germany
| | - Holger Sudhoff
- Department of Otorhinolaryngology, Head and Neck Surgery, Academic Teaching Hospital Bielefeld, Bielefeld, Germany
| | - Christian Junghanß
- Division of Medicine, Department of Hematology, Oncology and Palliative Medicine, University of Rostock, Rostock, Germany
| | - Claus Wittekindt
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Giessen and Marburg, Giessen, Germany
| | - Katharina Pachmann
- Clinic of Internal Medicine II, Division of Hematology and Internal Oncology, Jena University Hospital, Erlanger Allee 101, Jena, Germany
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Inhestern J, Stemmann V, Pachmann K, Guntinas-Lichius O. P39 Behavior of circulating tumor cells in patients with locally advanced squamous cell carcinoma of the head and neck during therapy: A prospective study. Oral Oncol 2015. [DOI: 10.1016/j.oraloncology.2015.02.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Inhestern J, Schuerer J, Illge C, Thanos I, Meissner W, Volk GF, Guntinas-Lichius O. Pain on the first postoperative day after head and neck cancer surgery. Eur Arch Otorhinolaryngol 2014; 272:3401-9. [PMID: 25261106 DOI: 10.1007/s00405-014-3307-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 09/22/2014] [Indexed: 11/27/2022]
Abstract
Postoperative pain within the first 24 h after head and neck cancer (HNC) surgery was assessed. Factors influencing postoperative pain were identified. In a prospective cohort single center study 145 HNC patients rated their pain on the first postoperative day using questionnaires of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including numeric rating scales (NRS, 0-10) for the determination of patient's pain on ambulation, his maximal and minimal pain. QUIPS allowed a standardized assessment of patients' characteristics and pain-related parameters. The influence of these parameters on the patients' postoperative pain was estimated by univariate and multivariate statistical analysis. One-third had already pain prior to the surgical intervention. Overall, the mean pain on ambulation, maximal pain and minimal pain were 2.55 ± 2.36, 3.18 ± 2.86, and 1.38 ± 2.86 (NRS), respectively. 53 % of the patients had maximal pain scores >3. Multivariate analysis revealed independent predictors for more postoperative pain on ambulation: intensity of chronic preoperative pain, usage of non-opioids on ward, and existence of pain documentation on ward. Intensity of chronic preoperative pain and usage of non-opioids on ward were independent risk factors for more maximal pain. Intensity of chronic preoperative pain was independently associated to more minimal pain. Concerning pain management side effects, the risk for drowsiness increased with longer time of surgery. Postoperative pain after HNC surgery is highly variable and seems often to be unnecessarily high. Many patients seem to receive less analgesia than needed or ineffective analgesic drug regimes.
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Affiliation(s)
- Johanna Inhestern
- Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany
| | - Jenny Schuerer
- Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany
| | - Christina Illge
- Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany
| | - Ira Thanos
- Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany
| | - Winfried Meissner
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | - Gerd Fabian Volk
- Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany.
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Oemus D, Inhestern J, Schmalenberg H, Schultze-Mosgau S, Mentzel HJ, Guntinas-Lichius O. Prognostic value of tumor volumetry data of routine imaging data in a head and neck cancer registry. Eur Arch Otorhinolaryngol 2013; 271:2531-7. [DOI: 10.1007/s00405-013-2800-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 10/28/2013] [Indexed: 12/24/2022]
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Witt K, Inhestern J, Guntinas-Lichius O, Voss A. Application of an electronic nose to detect head and neck cancer from exhaled breath. BIOMED ENG-BIOMED TE 2012. [DOI: 10.1515/bmt-2012-4313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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