Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor, MI, United States.
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Am J Otolaryngol. 2022 May-Jun;43(3):103442. doi: 10.1016/j.amjoto.2022.103442. Epub 2022 Apr 5.
To assess the prevalence and predictors of mental health disorders (MDHs) among head and neck squamous cell carcinoma (HNSCC) survivors, and the association with health-related quality of life (HRQOL), pain, and survival outcomes.
This was a retrospective, cross-sectional study of HNSCC survivors surveyed at an outpatient oncology clinic from May 2012 through July 2016.
Among 198 HNSCC survivors, 21% reported a MHD. Female sex (OR 6.60, 95% CI 2.08 to 20.98; p = 0.001) and Medicare insurance status (OR 4.95, 95% CI 1.52 to 16.11; p = 0.008) were significant predictors of reporting a MHD in the fully adjusted model. Patients reporting a MHD reported significantly worse pain (p < 0001) and worse HRQOL on the PROMIS Physical (p < 0.001), PROMIS Mental (p < 0.001), and FACT-GP (p < 0.026) questionnaires. Diagnosis of a MHD was not correlated with 5-year OS (74% vs. 84%; p = 0.087).
Initiatives for early identification and intervention of MHDs as part of survivorship initiatives may engender clinically meaningful outcomes in head and neck cancer.
评估头颈部鳞状细胞癌（HNSCC）幸存者中心理健康障碍（MDH）的患病率和预测因素，以及与健康相关的生活质量（HRQOL）、疼痛和生存结果的关系。
这是一项回顾性、横断面研究，对 2012 年 5 月至 2016 年 7 月在门诊肿瘤诊所接受调查的 HNSCC 幸存者进行了研究。
在 198 名 HNSCC 幸存者中，21%报告有 MDH。女性（OR 6.60，95%CI 2.08 至 20.98；p=0.001）和医疗保险状态（OR 4.95，95%CI 1.52 至 16.11；p=0.008）是报告 MDH 的全调整模型中的显著预测因素。报告 MDH 的患者报告疼痛明显更严重（p<0001），并且在 PROMIS 物理（p<0.001）、PROMIS 心理（p<0.001）和 FACT-GP（p<0.026）问卷上的 HRQOL 也明显更差。MDH 的诊断与 5 年 OS 无相关性（74%比 84%；p=0.087）。
作为生存倡议的一部分，针对 MDH 的早期识别和干预的倡议可能会对头颈癌产生有临床意义的结果。
