4.4 Article

Prospective quality of life outcomes for human papillomavirus associated oropharynx cancer patients after surgery alone

期刊

AMERICAN JOURNAL OF OTOLARYNGOLOGY
卷 44, 期 4, 页码 -

出版社

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.amjoto.2023.103915

关键词

Human papillomavirus; Oropharynx cancer; Patient reported outcomes; Quality of life; Oropharynx squamous cell carcinoma; p16

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The purpose of this study was to evaluate changes in patient-reported quality of life (QOL) for HPV+ OPSCC patients and inform treatment decisions. The results showed that most patients had a high QOL post-treatment, with only a few experiencing mild taste and smell dysfunction. Surgery alone offers favorable QOL outcomes for HPV + OPSCC patients.
Purpose: To evaluate changes in patient-reported quality of life (QOL) to inform treatment decisions for human papillomavirus-associated oropharynx squamous cell carcinoma (HPV + OPSCC).Materials and methods: Patients with American Joint Committee on Cancer (AJCC) 8th edition cT0-T3 and cN0-N3 HPV + OPSCC treated with transoral robotic surgery to the primary site with neck dissection completed questionnaires prior to surgery and at three-months and one-year post-operatively. Questionnaires included four validated instruments: the University of Washington Quality of Life Questionnaire (UW-QOL), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and Head and Neck Module (HN35), and the Neck Dissection Impairment Index (NDII).Results: Forty-eight patients filled out pretreatment and three-month questionnaires. 37 patients filled out oneyear questionnaires. With the UW-QOL, at three-months, patients reported a statistically significant and clinically meaningful decreased mean score for appearance that resolved at one-year (presurgery: 92.4, 3-month: 81.0, p < 0.001; one year: 86.5). At three months and one-year, significant and clinically meaningful decreased mean taste scores persisted (presurgery: 98.0; three-months: 76.3, one-year: 80.3; all p < 0.001). With the EORTC QLQ-C30 and HN35, at one-year, only mean scores for sense of taste or smell (one-year: 13.1; p < 0.001) did not return to baseline. With the NDII, patients returned to functions comparable to baseline in all domains.Conclusion: Post-treatment quality of life is high for HPV+ OPSCC patients treated with surgery alone. Mild taste and possibly smell dysfunction may continue in some patients. With careful selection, surgery alone for HPV + OPSCC offers favorable QOL outcomes.

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