Assessing Long-Term Quality of Life Concerns Through Survivorship Clinic in Head and Neck Cancer Patients

Otolaryngol Head Neck Surg. 2025 Jan;172(1):167-175. doi: 10.1002/ohn.985. Epub 2024 Oct 1.

Abstract

Objective: To characterize the concerns of head and neck cancer (HNC) patients and discern changes in quality-of-life (QoL) during long-term follow-up.

Study design: Retrospective review.

Setting: Survivorship clinic at a tertiary academic center.

Methods: A retrospective review was conducted on HNC patients seen in our survivorship clinic between 1/2020 and 1/2024 using the University of Washington Quality of Life (UW-QOL) Questionnaire.

Results: Three hundred and forty-two patients were seen for 914 encounters. Patients were divided into 4 groups: pretreatment (n = 326), 0 to 12 months posttreatment (n = 247), 1 to 3 years posttreatment (n = 248), and more than 3 years posttreatment (n = 64). The average follow-up after treatment was 459 days (range: 0-5.2 years). Multivariable analysis revealed significant improvements in overall QoL, health-related QoL, social-emotional composite scores, activity, anxiety, appearance, chewing, mood, pain, speech, and recreation at more than 1-year posttreatment compared to less than 1-year posttreatment. However, declines were noted in saliva and taste scores. No differences in scores were observed between patients 1 to 3 years posttreatment and those >3 years posttreatment. At all timepoints before and after treatment, top concerns were pain, activity, and swallowing. Patients with oral cancer followed for more than 1-year posttreatment had worse scores in appearance, chewing, pain, and speech compared to those with oropharyngeal cancer.

Conclusions: Understanding the evolving concerns of HNC patients is imperative for enhancing care. Most QoL domains improve at 1-year posttreatment except for saliva, taste, swallowing, and shoulder function. QoL scores stabilize after 1-year post-treatment. Pain, activity, and swallowing remain the top concerns at all time points.

Keywords: UW‐QOL, quality of life; head and neck cancer; survivorship.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cancer Survivors / psychology
  • Female
  • Head and Neck Neoplasms* / psychology
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Male
  • Middle Aged
  • Quality of Life*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Survivorship