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J Cancer 2024; 15(7):1805-1815. doi:10.7150/jca.92400 This issue Cite

Research Paper

Survival-weighted quality of life profiles in patients treated for laryngeal and hypopharyngeal cancers

Yao-Te Tsai^1,2, Ku-Hao Fang^2,3, Wen-Cheng Chen^2,4, Andrea De Vito⁵, Chun-Ta Liao^2,3, Chung-Jan Kang^2,3, Cheng-Ming Hsu^1,2, Ethan I. Huang^1,2, Ming-Shao Tsai^1,2, Geng-He Chang^1,2, Yi-Chan Lee^2,6, Chia-Hsuan Lai^2,4✉

1. Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
2. College of Medicine, Chang Gung University, Taoyuan, Taiwan.
3. Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.
4. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
5. Ear Nose Throat (ENT) Unit, Department of Surgery, Forlì Hospital Health Local Agency of Romagna, Italy.
6. Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan.

✉ Corresponding author: Chia-Hsuan Lai; Address: No.6, W. Sec., Jiapu Rd., Puzi City, Chiayi, Taiwan 613016; Phone: +886-5-3621000 ext. 3726; E-mail: chiahsuan7092com.

Abstract

Objectives: This study assessed functional outcomes and quality of life (QoL) in the long term in individuals treated for laryngohypopharyngeal cancer (LHC) by estimating their life expectancy (LE), survival-weighted psychometric scores (SWPSs), and quality-adjusted LE (QALE).

Materials and methods: To estimate survival outcomes, we retrospectively reviewed the data of 1576 patients treated for primary LHC between January 2010 and December 2018 and followed them until death or December 2020. We also prospectively collected QoL and functional data between October 2013 and November 2022 from 232 patients by administering the Taiwanese Chinese versions of the QoL Questionnaire Core 30, Head and Neck 35, and EQ-5D-3L. To estimate LE, we employed linear extrapolation of a logit-transformed curve. We calculated QALE and SWPSs by combining the QoL data with the LE results.

Results: We estimated the LE of the patients with LHC to be 7.8 years and their loss of LE to be 15.7 years. The estimated QALE was 7.0 QALYs, with a loss of QALE of 16.5 QALYs. Lifetime impairment durations were estimated for cognitive (4.9 years), physical (4.2 years), emotional (3.4 years), social (3.4 years), and role functions (2.7 years). We estimated the durations of problems related to swallowing, speech, and teeth to be 6.2, 5.6, and 4.8 years, respectively. The patients were expected to be dependent on feeding tubes for 1.2 years.

Conclusions: Patients with LHC experience significant reductions in both LE and QALE. SWPSs may constitute a valuable tool for obtaining subjective information regarding how LHC affects multifaceted QoL outcomes.

Keywords: laryngohypopharyngeal cancer, life expectancy, quality of life, quality-adjusted life expectancy, survival-weighted psychometric scores

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