Abstract Purpose Head and neck squamous cell carcinoma (HNSCC) significantly impacts patients’ quality of life (QoL). This study investigated long-term QoL outcomes among 619 patients with newly diagnosed HNSCC over five years. Methods QoL was assessed annually using the SF-36, covering physical functioning, emotional well-being, social functioning, pain, and general health. Patients were stratified by tumor subsite and smoking status. Results Significant improvements in QoL were observed at the 1-year follow-up, particularly among patients with pharyngeal adjusted β: 3.56 (95% CI: 1.69, 5.43) and oral cavity cancers adjusted β: 2.56 (95% CI: 0.52, 4.60). However, patients with laryngeal cancer showed no significant change at any follow-up e.g., 1-year adjusted β: 0.93 (95% CI: -2.36, 4.24). Overall, QoL improved most notably in the early years post-treatment adjusted β: 2.86 (95% CI: 1.56, 4.16). Smoking status significantly influenced QoL trajectories. Never-smokers showed the greatest improvement (from 53.11 at baseline to 59.29 at year 2, P < 0.0001), followed by quitters (48.09 to 51.42, P = 0.04). Continued and intermittent smokers demonstrated no significant gains. Conclusions In this longitudinal study of HNSCC patients, quality of life significantly improved over time, particularly among those with pharyngeal and oral cavity tumors and those who never smoked or quit smoking after diagnosis. Implications for Cancer Survivors These findings highlight the importance of smoking cessation in survivorship care. Personalized care strategies addressing both physical and psychosocial challenges, particularly for continued smokers and those with laryngeal tumors, are essential to improving long-term QoL in HNSCC survivors.
Mohebbi et al. (Mon,) studied this question.