Department of Surgical Sciences, Faculty of Medicine, University of Bergen, Bergenm Norway.
JAMA Otolaryngol Head Neck Surg. 2013 Jan;139(1):14-20. doi: 10.1001/jamaoto.2013.1056.
To evaluate the association between pretreatment health-related quality-of-life (HRQOL) scores and survival in a heterogeneous cohort of patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC).
Prospective cohort study.
University hospital and referral center in Western Norway.
A total of 106 patients with intact cognitive functioning who were younger than 78 years, were diagnosed as having HNSCC, and underwent treatment with curative intent from November 1, 2002, through June 30, 2005.
Overall survival and HRQOL scores obtained at the time of diagnosis.
All dichotomized HRQOL sum scores except the functional score (P = .20) were significantly predictive of survival in univariate analyses. The hazard ratios of the dichotomized general symptom, global quality-of-life, and head and neck sum score were 3.66, 0.31, and 2.28, respectively. All sum scores except the dichotomized functional score remained predictive of survival after sequential adjustment for sociodemographic and clinical characteristics, neuroticism, choice of psychological coping, current smoking and alcohol consumption, and comorbidities. Similar findings were found for specific HRQOL indices of physical functioning, dyspnea, sleep disturbance, appetite loss, swallowing, and social eating from the European Organization for Research and Treatment of Cancer 30-Item Core Quality of Life Questionnaire, version 3.0, and the Quality of Life-Head and Neck Cancer Module. Moreover, patients in the highest scoring quartiles for the symptom sum scores and/or the lowest scoring quartile for the global score had overall mortality rates of 50% to 64% compared with 23% to 26% among the other patients.
The HRQOL sum scores and specific indices among HNSCC patients predict survival independently of established known prognostic factors.
评估新诊断的头颈部鳞状细胞癌（HNSCC）患者异质队列中治疗前健康相关生活质量（HRQOL）评分与生存之间的关系。
前瞻性队列研究。
挪威西部的大学医院和转诊中心。
共 106 名认知功能完整、年龄小于 78 岁、被诊断为 HNSCC 且于 2002 年 11 月 1 日至 2005 年 6 月 30 日接受根治性治疗的患者。
总体生存率和诊断时的 HRQOL 评分。
在单因素分析中，除功能评分外（P =.20），所有二分 HRQOL 总分均与生存显著相关。二分一般症状、总体生活质量和头颈部总分的危险比分别为 3.66、0.31 和 2.28。除二分功能评分外，所有总分在按社会人口学和临床特征、神经质、心理应对选择、当前吸烟和饮酒以及合并症进行连续调整后仍与生存相关。在欧洲癌症研究与治疗组织 30 项核心生活质量问卷（版本 3.0）和生活质量-头颈部癌症模块的特定 HRQOL 指标（包括身体功能、呼吸困难、睡眠障碍、食欲减退、吞咽和社交进食）中也发现了类似的结果。此外，症状总分得分最高的四分位数和/或总体得分最低的四分位数患者的总死亡率为 50%至 64%，而其他患者的死亡率为 23%至 26%。
HNSCC 患者的 HRQOL 总分和特定指标独立于既定的已知预后因素预测生存。
