Aarstad Hans Jørgen, Osthus Arild Andrè, Olofsson Jan, Aarstad Anne K H
Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen.
Acta Otolaryngol. 2014 Feb;134(2):211-9. doi: 10.3109/00016489.2013.841989. Epub 2013 Nov 21.
Our findings indicate a unique survival prediction from general health questionnaire (GHQ) sum scores in successfully treated head and neck squamous cell carcinoma (HNSCC) patients and also to some extent with inclusion of health-related quality of life (HRQoL) scores.
To examine the survival prediction from the level of distress, measured by GHQ scores obtained from at inclusion successfully treated HNSCC patients.
Structured interviews were conducted for 135 successfully treated cognitive functioning HNSCC patients 67 ± 31 (mean ± SD) months after diagnosis following a regular follow-up visit. GHQ scores, alcohol consumption history, smoking status, present comorbidities, level of neuroticism, choice of psychological coping with the cancer disease, and HRQoL scores (EORTC QLQ-C30 and -H&N35) were determined. The TNM stage, treatment provided and tumour site were obtained from the hospital records. Forty-three deaths were noted during a minimum 8.5 years of observation.
The GHQ sum scores predicted survival in univariate (p < 0.05) and multivariate analyses with the above-mentioned covariates included (p < 0.01). Using clinically relevant cut-off levels, GHQ scores predicted survival in both univariate (hazard ratio (HR) 1.9; p = 0.05) and multivariate Cox regression analyses (HR 3.8; p = 0.001). We also demonstrated survival prediction from GHQ scores when adjusted by HRQoL scores.
我们的研究结果表明，在成功治疗的头颈部鳞状细胞癌（HNSCC）患者中，一般健康问卷（GHQ）总分具有独特的生存预测价值，在一定程度上纳入健康相关生活质量（HRQoL）评分后也是如此。
通过对成功治疗的HNSCC患者纳入时获得的GHQ评分来检测痛苦程度对生存的预测作用。
在定期随访诊断后67±31（均值±标准差）个月，对135例成功治疗的认知功能HNSCC患者进行结构化访谈。测定GHQ评分、饮酒史、吸烟状况、当前合并症、神经质水平、应对癌症疾病的心理方式选择以及HRQoL评分（欧洲癌症研究与治疗组织QLQ-C30和-H&N35）。TNM分期、所提供的治疗和肿瘤部位从医院记录中获取。在至少8.5年的观察期内记录到43例死亡。
在单变量分析（p<0.05）以及纳入上述协变量的多变量分析中（p<0.01），GHQ总分可预测生存情况。使用临床相关的临界值水平，GHQ评分在单变量（风险比（HR）1.9；p = 0.05）和多变量Cox回归分析（HR 3.8；p = 0.001）中均能预测生存。我们还证明了在通过HRQoL评分进行调整后，GHQ评分仍具有生存预测价值。
