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Sociodemographic factors and quality of life as prognostic indicators in head and neck cancer
Abstract
Pre-treatment quality of life (QOL) has been found to be an independent prognostic factor for survival in cancer patients, in particular in patients with advanced cancer. Sociodemographic factors such as marital and socioeconomic status have also been recognised as prognostic factors. We studied the influence of QOL and mood (measured with the European Organization for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30) and the Head and Neck Cancer Questionnaire (EORTC QLQ-H&N35), and with the Center for Epidemiologic Studies-Depression Scale (CES-D)) as measured before treatment, the use of cigarettes and alcohol and sociodemographic factors (age, gender, marital status, income and occupation) on recurrence and survival in 208 patients with head and neck cancer prior to treatment with surgery and/or radiotherapy, using Kaplan-Meier and Cox regression analyses. Cognitive functioning and, to a lesser degree, marital status were independent predictors of recurrence and survival, along with medical factors (stage and radicality). Patients with less than optimal cognitive functioning and unmarried patients had a relative risk (RR) of recurrence of 1.72 (95% confidence interval (95% CI) 1.01-2.93) and 1.85 (95% CI 1.06-3.33), respectively, and a RR of dying of 1.90 (95% CI 1.10-3.26) and 1.82 (95% CI 1.03-3.23), respectively. Performance status, physical functioning, mood and global QOL and smoking and drinking did not predict for recurrence and survival. The influence of cognitive functioning might be related to the use of alcohol. Marital status may influence prognosis through mechanisms of health behaviour and/or social support mechanisms.
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“Since poor QoL is associated with a higher risk of mortality in HNC patients [55–57], and psychological interventions targeting body image distress and pain have shown their effectiveness [58], focusing on these dimensions before HNC treatment might be crucial for improving patients’ overall QoL and survival rates.”
From Psychological variables associated with quality of life in patients with head and neck cancer: the role of body image distress (2022) · cites this paper as [55]
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“[46] observed that marital status and social ctivity were univariate predictors of survival but were no onger significant in multivariate analysis that controlled for onfounding variables.”
BackgroundClinical Predictors of Quality of Life in Patients With Head and Neck Cancer
Terrell, J. E., Ronis, D. L., Fowler, K. E., Bradford, C. R., Chepeha, D. B., Prince, M. E. P., Teknos, T. N., Wolf, G. T., & Duffy, S. A. (2004) · Archives of Otolaryngology - Head and Neck Surgery · doi:10.1001/archotol.130.4.401 · Cited by 454
Metadata
- Authors
- de Graeff, A., de Leeuw, J. R. J., Ros, W. J. G., Hordijk, G. J., Blijham, G. H., & Winnubst, J. A. M.
- Affiliations
- University Medical Center Utrecht (NL)
- ORCID
- Ros, W.J.G
- Venue
- European Journal of Cancer
- Publisher
- Elsevier BV
- Published
- 2001-02
- Volume
- 37
- Issue
- 3
- Pages
- 332-339
- ISSN
- 0959-8049 (ISSN-L)
- OpenAlex
- W2080391410
- Cited by
- 199
- References
- 51
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 6 · 2023: 3 · 2022: 12 · 2021: 2 · 2020: 3 · 2019: 7 · 2018: 9 · 2017: 8 · 2016: 7 · 2015: 8 · 2014: 12 · 2013: 7 · 2012: 11
- FWCI
- 8.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Keywords
- head and neck cancer, quality of life, prognostic factors, recurrence, survival, sociodemographic factors, marital status, cognitive function, mood, depression, smoking, alcohol consumption, socioeconomic status, EORTC QLQ-H&N35, EORTC QLQ-C30, social support
- MeSH terms
- Alcohol Drinking, Female, Head and Neck Neoplasms, Humans, Male, Neoplasm Recurrence, Local, Prognosis, Prospective Studies, Quality of Life, Risk Factors, Smoking, Socioeconomic Factors, Multivariate Analysis, Survival Analysis
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