Anxiety, depression and quality of life in patients with head and neck cancer undergoing laryngectomy: A long-term prospective evaluation.
HADS
SF‐8
head and neck cancer
laryngectomy
quality of life
Journal
International journal of language & communication disorders
ISSN: 1460-6984
Titre abrégé: Int J Lang Commun Disord
Pays: United States
ID NLM: 9803709
Informations de publication
Date de publication:
22 Apr 2024
22 Apr 2024
Historique:
received:
14
09
2023
accepted:
09
04
2024
medline:
22
4
2024
pubmed:
22
4
2024
entrez:
22
4
2024
Statut:
aheadofprint
Résumé
This study aimed to assess anxiety, depression and quality of life (QoL) in patients with head and neck cancer undergoing laryngectomy using comprehensive self-reported questionnaires for a period of up to 5 years. This prospective observational study enrolled 150 consecutive patients with locally advanced head and neck cancer who underwent laryngectomy at Nagoya University Hospital between 2007 and 2020. Anxiety, depression and QoL were assessed at baseline (preoperative) and at 3, 6, 12, 24, 36, 48 and 60 months after surgery using two brief self-reported questionnaires, such as the eight-item Short Form Health Survey (SF-8) and the Hospital Anxiety and Depression Scale (HADS). The surgical procedures were total laryngectomy, pharyngo-laryngectomy and pharyngo-laryngo-oesophagectomy in 97 (65%), 41 (27%) and 12 (8%) patients, respectively. All eight items of the SF-8 were significantly worse than those of the normal population at baseline and at 3 months after surgery. However, general health, vitality, mental health and bodily pain improved to normal levels within 1 year after surgery and were maintained for 5 years. In this study, 35% of patients were categorised as potential cases of depression, and 35% were potential cases of anxiety. During the follow-up period, the proportion of patients with anxiety gradually decreased after surgery. Further analysis revealed that the SF-8 and HADS scores and trends in 89 patients without tumour recurrence were similar to those in the total enrolled 150 patients. Anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years. What is already known on the subject Laryngectomy is associated with prolonged functional and psychological effects and has a major impact on patient quality of life (QoL). Several prospective studies evaluating the QoL in laryngectomised patients have been reported, in which significant deterioration in social functioning was found even 1 year after surgery. What this paper adds to existing knowledge One year is not a sufficient period for laryngectomised patients to return to normal life and spend their time in a social community. A recent review showed that most studies on QoL in laryngectomised patients were conducted under 1 year after the procedure, and there were not enough studies of sufficient quality. This is the first long-term prospective observational study of Japanese patients with head and neck cancer who underwent laryngectomy up to 5 years after surgery. What are the potential or actual clinical implications of this work? Our long-term observational study showed that the scores for anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years. Clinicians should recognize the importance of psychosocial risk factors in their QoL and multidisciplinary management, including social and psychological support, is essential for long-term laryngectomised survivors.
Sections du résumé
BACKGROUND
BACKGROUND
This study aimed to assess anxiety, depression and quality of life (QoL) in patients with head and neck cancer undergoing laryngectomy using comprehensive self-reported questionnaires for a period of up to 5 years.
METHODS
METHODS
This prospective observational study enrolled 150 consecutive patients with locally advanced head and neck cancer who underwent laryngectomy at Nagoya University Hospital between 2007 and 2020. Anxiety, depression and QoL were assessed at baseline (preoperative) and at 3, 6, 12, 24, 36, 48 and 60 months after surgery using two brief self-reported questionnaires, such as the eight-item Short Form Health Survey (SF-8) and the Hospital Anxiety and Depression Scale (HADS).
RESULTS
RESULTS
The surgical procedures were total laryngectomy, pharyngo-laryngectomy and pharyngo-laryngo-oesophagectomy in 97 (65%), 41 (27%) and 12 (8%) patients, respectively. All eight items of the SF-8 were significantly worse than those of the normal population at baseline and at 3 months after surgery. However, general health, vitality, mental health and bodily pain improved to normal levels within 1 year after surgery and were maintained for 5 years. In this study, 35% of patients were categorised as potential cases of depression, and 35% were potential cases of anxiety. During the follow-up period, the proportion of patients with anxiety gradually decreased after surgery. Further analysis revealed that the SF-8 and HADS scores and trends in 89 patients without tumour recurrence were similar to those in the total enrolled 150 patients.
CONCLUSION
CONCLUSIONS
Anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years.
WHAT THIS PAPER ADDS
CONCLUSIONS
What is already known on the subject Laryngectomy is associated with prolonged functional and psychological effects and has a major impact on patient quality of life (QoL). Several prospective studies evaluating the QoL in laryngectomised patients have been reported, in which significant deterioration in social functioning was found even 1 year after surgery. What this paper adds to existing knowledge One year is not a sufficient period for laryngectomised patients to return to normal life and spend their time in a social community. A recent review showed that most studies on QoL in laryngectomised patients were conducted under 1 year after the procedure, and there were not enough studies of sufficient quality. This is the first long-term prospective observational study of Japanese patients with head and neck cancer who underwent laryngectomy up to 5 years after surgery. What are the potential or actual clinical implications of this work? Our long-term observational study showed that the scores for anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years. Clinicians should recognize the importance of psychosocial risk factors in their QoL and multidisciplinary management, including social and psychological support, is essential for long-term laryngectomised survivors.
Identifiants
pubmed: 38647077
doi: 10.1111/1460-6984.13036
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Japan Agency for Medical Research and Development
Organisme : JP21dk0310114
Informations de copyright
© 2024 Royal College of Speech and Language Therapists.
Références
Adachi, Y., Kimura, H. & Sato, N., et al. (2014) Preoperative level of depression is a predictor of postoperative levels of depression in patients with head and neck cancer. Japanese Journal of Clinical Oncology, 44(4), 311–317. https://doi.org/10.1093/jjco/hyu002
American Psychiatric Publishing (2013) Diagnostic and statistical manual of mental disorders. 5th ed. Washington. DC: American Psychiatric Publishing.
Bjordal, K., Ahlner‐Elmqvist, M., Hammerlid, E., et al. (2001) A prospective study of quality of life in head and neck cancer patients. Part II: longitudinal data. Laryngoscope, 111(8), 1440–1452. https://doi.org/10.1097/00005537‐200108000‐00022
Bozec, A., Boscagli, M., Serris, M., et al. (2021) Long‐term functional and quality of life outcomes in laryngectomized patients after successful voice restoration using tracheoesophageal prostheses. Surgical Oncology, 38, 101580. https://doi.org/10.1016/j.suronc.2021.101580
Bozec, A., Schultz, P., Gal, J., et al. (2019) Evaluation of the information given to patients undergoing total pharyngolaryngectomy and quality of life: a prospective multicentric study. European Archives of Oto‐Rhino‐Laryngology, 276(9), 2531–2539. https://doi.org/10.1007/s00405‐019‐05513‐6
Bussian, C., Wollbrück, D., Danker, H., et al. (2010) Mental health after laryngectomy and partial laryngectomy: a comparative study. European Archives of Oto‐Rhino‐Laryngology, 267(2), 261–266. https://doi.org/10.1007/s00405‐009‐1068‐7
Cocuzza, S., Maniaci, A., Grillo, C., et al. (2020) Voice‐related quality of life in post‐laryngectomy rehabilitation: tracheoesophageal fistula's wellness. International Journal of Environmental Research and Public Health, 17(12), 4605. https://doi.org/10.3390/ijerph17124605
Eadie, T.L., Day, A.M., Sawin, D.E., Lamvik, K. & Doyle, P.C. (2013) Auditory‐perceptual speech outcomes and quality of life after total laryngectomy. Otolaryngology–Head and Neck Surgery: Official Journal of American Academy of Otolaryngology‐Head and Neck Surgery, 148(1), 82–88. https://doi.org/10.1177/0194599812461755
Evans, E., Carding, P. & Drinnan, M. (2009) The voice handicap index with post‐laryngectomy male voices. International Journal of Language & Communication Disorders, 44(5), 575–586. https://doi.org/10.1080/13682820902928729
Fukuhara, S. & Suzukamo, Y. (2004) Manual of the SF‐8 Japanese version. Kyoto: Institute for Health Outcomes and Process Evaluation Research (in Japanese).
Giordano, L., Toma, S., Teggi, R., et al. (2011) Satisfaction and quality of life in laryngectomees after voice prosthesis rehabilitation. Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP), 63(5), 231–236. https://doi.org/10.1159/000323185
Holloway, R.L., Hellewell, J.L., Marbella, A.M., Layde, P.M., Myers, K.B. & Campbell, B.H. (2005) Psychosocial effects in long‐term head and neck cancer survivors. Head & Neck, 27(4), 281–288. https://doi.org/10.1002/hed.20147
Hutcheson, K.A., Alvarez, C.P., Barringer, D.A., Kupferman, M.E., Lapine, P.R. & Lewin, J.S. (2012) Outcomes of elective total laryngectomy for laryngopharyngeal dysfunction in disease‐free head and neck cancer survivors. Otolaryngology–Head and Neck Surgery: Official Journal of American Academy of Otolaryngology‐Head and Neck Surgery, 146(4), 585–590. https://doi.org/10.1177/0194599811432264
Kugaya, A., Akechi, T., Okuyama, T., Okamura, H. & Uchitomi, Y. (1998) Screening for psychological distress in Japanese cancer patients. Japanese Journal of Clinical Oncology, 28(5), 333–338. https://doi.org/10.1093/jjco/28.5.333
Leemans, M., van Sluis, K.E., van Son, R. & van den Brekel, M.W.M. (2020) Interaction of functional and participation issues on quality of life after total laryngectomy. Laryngoscope Investigative Otolaryngology, 5(3), 453–460. https://doi.org/10.1002/lio2.381
Mukoyama, N., Nishio, N. & Kimura, H., et al. (2020) Prospective evaluation of health‐related quality of life in patients undergoing anterolateral craniofacial resection with orbital exenteration. Journal of Neurological Surgery. Part B, Skull Base, 81(5), 585–593. https://doi.org/10.1055/s‐0039‐1694010
Perry, A., Casey, E. & Cotton, S. (2015) Quality of life after total laryngectomy: functioning, psychological well‐being and self‐efficacy. International Journal of Language & Communication Disorders, 50(4), 467–475. https://doi.org/10.1111/1460‐6984.12148
Robertson, S.M., Yeo, J.C., Dunnet, C., Young, D. & Mackenzie, K. (2012) Voice, swallowing, and quality of life after total laryngectomy: results of the west of Scotland laryngectomy audit. Head & Neck, 34(1), 59–65. https://doi.org/10.1002/hed.21692
Rogers, S.N., Ahad, S.A. & Murphy, A.P. (2007) A structured review and theme analysis of papers published on “quality of life” in head and neck cancer: 2000–2005. Oral Oncology, 43(9), 843–868. https://doi.org/10.1016/j.oraloncology.2007.02.006
Rolstad, S., Adler, J. & Rydén, A. (2011) Response burden and questionnaire length: is shorter better? A review and meta‐analysis. Value in Health., 14(8), 1101–1108. https://doi.org/10.1016/j.jval.2011.06.003
Roux, M., Dassonville, O., Ettaiche, M., Chamorey, E., Poissonnet, G. & Bozec, A. (2017) Primary total laryngectomy and pharyngolaryngectomy in T4 pharyngolaryngeal cancers: oncologic and functional results and prognostic factors. European Annals of Otorhinolaryngology, Head and Neck Diseases, 134(3), 151–154. https://doi.org/10.1016/j.anorl.2016.11.009
Schuster, M., Lohscheller, J., Kummer, P., Hoppe, U., Eysholdt, U. & Rosanowski, F. (2003) Quality of life in laryngectomees after prosthetic voice restoration. Folia Phoniatrica et Logopaedica: Official Organ of the International Association of Logopedics and Phoniatrics (IALP), 55(5), 211–219. https://doi.org/10.1159/000072152
Sharpe, G., Camoes Costa, V., Doubé, W., Sita, J., McCarthy, C. & Carding, P. (2019) Communication changes with laryngectomy and impact on quality of life: a review. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 28(4), 863–877. https://doi.org/10.1007/s11136‐018‐2033‐y
Singer, S., Danker, H., Guntinas‐Lichius, O., et al. (2014) Quality of life before and after total laryngectomy: results of a multicenter prospective cohort study. Head & Neck, 36(3), 359–368. https://doi.org/10.1002/hed.23305
Suzuki, K., Nishio, N., Kimura, H., et al. (2023) Comparison of quality of life and psychological distress in patients with tongue cancer undergoing a total/subtotal glossectomy or extended hemiglossectomy and free flap transfer: a prospective evaluation. International Journal of Oral and Maxillofacial Surgery, 52(6), 621–629. https://doi.org/10.1016/j.ijom.2022.11.010
Theunissen, E.A., Timmermans, A.J., Zuur, C.L., et al. (2012) Total laryngectomy for a dysfunctional larynx after (chemo)radiotherapy. Archives of Otolaryngology–Head & Neck Surgery, 138(6), 548–555. https://doi.org/10.1001/archoto.2012.862
Thom, L., Lowe, D. & Rogers, S.N. (2022) Implications of the Quality of Life Metric in head and neck cancer. The British Journal of Oral & Maxillofacial Surgery, 60(6), 810–816. https://doi.org/10.1016/j.bjoms.2021.12.005
van Sluis, K.E., van der Molen, L., van Son, R., et al. (2018) Objective and subjective voice outcomes after total laryngectomy: a systematic review. European Archives of Oto‐Rhino‐Laryngology, 275(1), 11–26. https://doi.org/10.1007/s00405‐017‐4790‐6
Ware, J.E., Kosinski, M., Dewey, J.E. & Gandek, B. (2001) How to score and interpret single‐item health status measures: A manual for users of the SF‐8 health survey. Lincoln, RI: QualityMetric Incorporated LLC.
Wulff, N.B., Højager, A., Wessel, I., Dalton, S.O. & Homøe, P. (2021) Health‐related quality of life following total laryngectomy: a systematic review. Laryngoscope, 131(4), 820–831. https://doi.org/10.1002/lary.29027
Zenga, J., Goldsmith, T., Bunting, G. & Deschler, D.G. (2018) State of the art: rehabilitation of speech and swallowing after total laryngectomy. Oral Oncology, 86, 38–47. https://doi.org/10.1016/j.oraloncology.2018.08.023
Zigmond, A.S. & Snaith, R.P. (1983) The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600‐0447.1983.tb09716.x