Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Mar 15;120(6):840-7.
doi: 10.1002/cncr.28482. Epub 2013 Dec 18.

Baseline health perceptions, dysphagia, and survival in patients with head and neck cancer

Miriam N Lango  1 , Brian Egleston, Carolyn Fang, Barbara Burtness, Thomas Galloway, Jeffrey Liu, Ranee Mehra, Barbara Ebersole, Kathleen Moran, John A Ridge
Affiliations

Baseline health perceptions, dysphagia, and survival in patients with head and neck cancer

Miriam N Lango et al. Cancer. .

Abstract

Background: In head and neck cancer patients prior to treatment, dysphagia noted by patients is more common than aspiration on formal swallow studies. The authors hypothesized that patient-reported dysphagia impacts multiple domains of quality of life (QOL) and predicts disease recurrence and disease-related death.

Methods: The Swal-QOL, a dysphagia-specific, swallowing-related, QOL measure, and the EuroQOL-5D-3L were administered to 159 patients before treatment with curative intent in this prospective cohort study. Logistic regression analysis evaluated associations among clinical and subjective measures. Multivariable competing risk regression tested the impact of clinical, tumor, and patient-reported measures on survival.

Results: Baseline dysphagia, pain, and diminished patient-reported health state were found to be closely associated with weight loss before treatment and advanced T classification. However, only 58% of patients (23 of 40 patients) reporting dysphagia experienced > 5% weight loss. Dysphagia was found to be associated with pain and/or diminished patient-reported health state, independent of weight loss. Female patients were more likely to report pain and dysphagia, whereas male patients reported dysphagia alone. Dysphagia was found to be predictive of disease recurrence and disease-related death, adjusting for T and N classifications, ECOG performance status, smoking status, and weight loss, and accounting for competing risks of death (recurrence-free survival: hazards ratio, 3.8 [95% confidence interval, 1.7-8.4; P = .001] and disease-related death: hazards ratio, 4.2 [95% confidence interval, 1.04-5; P = .004]).

Conclusions: Baseline dysphagia affects multiple domains of QOL and general health perceptions in patients with head and neck cancer prior to treatment. A dysphagia measure captures the effort of maintaining nutrition, and identifies patients predisposed to disease recurrence and disease-related death.

Keywords: baseline weight loss; dysphagia; head and neck cancer; health perceptions; survival.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interests: None

References

    1. Maddox GL, Douglass EB. Self-assessment of health: a longitudinal study of elderly subjects. Journal of health and social behavior. 1973;14:87–93. - PubMed
    1. Winter L, Lawton MP, Langston CA, Ruckdeschel K, Sando R. Symptoms, affects, and self-rated health: evidence for a subjective trajectory of health. Journal of aging and health. 2007;19:453–469. - PubMed
    1. Li CL, Chang HY, Hsu CC, Lu JF, Fang HL. Joint predictability of health related quality of life and leisure time physical activity on mortality risk in people with diabetes. BMC public health. 2013;13:67. - PMC - PubMed
    1. Michaud K, Vera-Llonch M, Oster G. Mortality risk by functional status and health-related quality of life in patients with rheumatoid arthritis. The Journal of rheumatology. 2012;39:54–59. - PubMed
    1. Gotay CC, Kawamoto CT, Bottomley A, Efficace F. The prognostic significance of patient-reported outcomes in cancer clinical trials. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2008;26:1355–1363. - PubMed

Publication types

MeSH terms