Acceptance of Major Surgical Procedures and Quality of Life Among Long-term Survivors of Advanced Head and Neck Cancer

OBJECTIVE: To evaluate the acceptance of major surgical procedures and quality of life among long-term survivors of advanced head and neck cancer treated at a single institution. DESIGN: Cross-sectional analysis of a consecutive series of patients. SETTING: Tertiary care cancer center. PATIENTS: Participants had advanced (T3 and T4) head and neck cancer, had undergone a surgical procedure with or without postoperative radiotherapy, and had a minimum disease-free survival duration of 1 year. Eligible participants completed a questionnaire about their attitudes toward long-term outcomes and the University of Washington Quality of Life Questionnaire (UW-QOL). MAIN OUTCOME MEASURE: Descriptive analyses of the results and comparisons of the scores for each UW-QOL domain. RESULTS: A total of 273 patients were included in the study. Most were men (74.4%), with a median age of 56 years. The tumor site was the oral cavity in 101 patients (37.0%), larynx in 91 (33.3%), oropharynx in 64 (23.4%), and hypopharynx in 17 (6.2%). There were 167 patients (61.2%) with T3 tumors and 106 (38.8%) with T4 tumors. Adjuvant radiotherapy was performed in 153 patients (56.0%). Global quality of life was considered good to excellent by 162 patients (59.3%), and the mean UW-QOL composite score was 79.3. Most patients (91.2%) reported that they would undergo the same treatment if they had it to do again, and 95.6% reported that they would not like to exchange their present outcome for another treatment option with a lower chance of cure but with a possibly improved quality of life. CONCLUSION: In this series, the vast majority of patients considered a radical surgical procedure an acceptable treatment and reported a good quality of life.