Long-term survival and quality of life analysis in head and neck cancer survivors: An observational, cross-sectional study

头颈癌幸存者长期生存率和生活质量分析:一项观察性横断面研究

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Abstract

BACKGROUND: Head and neck cancer is a public health problem, and its treatment involves surgery and/or radio/chemotherapy. These procedures reduce the quality of life. To analyze survival in patients with head and neck cancer and survivors, the quality of life over 10 years. MATERIAL AND METHODS: An observational, cross-sectional, retrospective study was carried out on 460 medical records of patients diagnosed with head and neck cancer and treated at a referral hospital. Clinical pathological data were expressed in absolute and percentage frequencies, and the median survival time was calculated with their 95% confidence intervals using Kaplan-Meier curves. The curves were compared using the Log-Rank Mantel-Cox test and Cox regression. In survivors, we applied a quality of life (QoL) questionnaire where means and standard deviations of quality of life domains were calculated and compared using the Friedman/Dunn test and correlated with time after discharge using Spearman's correlation. Quality of life, classified as low or high with an average of 80 points, was associated with other clinical-pathological characteristics during the period of diagnosis using Pearson's chi-square test. All analyses performed adopted a 95% CI in the SPSS software. v20.0 for Windows. RESULTS: The medical records were analyzed; most of them were male, with a mean age of 61 years and a history of smoking and alcoholism. The most frequent staging was stage IV (T4, N2, M0). The most frequent location was the oropharynx, followed by the mouth. The median overall survival was 26.7 months (95% CI = 19.8-33.7). Of the 173 living patients, 41 (23.7%) responded to the questionnaire. Of the main problems related to QoL, swallowing (n = 10; 25.6%) was the most important, followed by chewing (n = 9; 28.1%) and saliva (n = 12; 42.9%). When QoL was associated with variables, it was observed that smoking (p = 0.014), alcoholism (p = 0.029), and time since discharge (p = 0.044) were associated with worse quality of life. CONCLUSIONS: Cancer treatment has numerous consequences for the quality of life of patients who have survived head and neck cancer. Further studies and differentiated plans are needed for the rehabilitation of these patients.

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