The effect of neck dissection on quality of life after chemoradiation

OBJECTIVE: To determine differences in quality of life (QOL) between patients with head and neck cancer who receive chemoradiation versus chemoradiation and neck dissection. METHODS: A prospective cohort study was conducted at two tertiary otolaryngology clinics and a Veterans Administration hospital. Sample: 103 oropharyngeal patients with Stage IV squamous cell carcinoma treated via chemoradiation +/- neck dissection. Intervention: self-administered health survey to collect health, demographic, and QOL information pretreatment and 1 year. later. Main outcome measures: QOL via SF-36 and HNQoL. Descriptive statistics were calculated for health/clinical characteristics, demo-graphics, and QOL scores. t tests evaluated changes in QOL over time. RESULTS: Sixty-five patients underwent chemoradiation and 38 patients underwent chemoradiation and neck dissection. Only the pain index of the SF-36 showed a significant difference between groups (P < 0.05) with the neck dissection group reporting greater pain. CONCLUSIONS: After post-treatment neck dissection, patients experience statistically significant decrement in bodily pain domain scores, but other QOL scores are similar to those of patients who underwent chemoradiation alone. (C) 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.