Health-Related Quality of Life, Satisfaction with Care, and Cosmetic Results in Relation to Treatment among Patients with Keratinocyte Cancer in the Head and Neck Area: Results from the PROFILES Registry

Abstract

Background: Little is known about the impact of keratinocyte cancer (KC) and its treatment on health-related quality of life (HRQoL).

Objectives: The objectives of the present study were (1) to evaluate HRQoL among patients with KC in a population-based setting and compare this with an age- end sex-matched normative population and (2) to compare HRQoL, satisfaction with care, and cosmetic results among patients who underwent conventional excision, Mohs' micrographic surgery, or radiotherapy.

Method: A random sample of 347 patients diagnosed with cutaneous basal cell or squamous cell carcinoma in the head and neck area between January 1, 2010, and December 31, 2014, were selected from the Netherlands Cancer Registry (NCR) and were invited to complete a questionnaire on HRQoL, satisfaction with care, and cosmetic results. Data were collected within Patient-Reported Outcomes Following Initial Treatment and Long-term Evaluation of Survivorship (PROFILES). Outcomes were compared to an age- and sex-matched normative population.

Results: Two hundred fifteen patients with KC returned a completed questionnaire (62% response). Patients with KC reported better global quality of life (79.6 vs. 73.3, p < 0.01) and less pain (p < 0.01) compared to the normative population. No statistically significant differences in HRQoL, satisfaction with care, and cosmetic results were found between patients with KC who underwent conventional excision, Mohs' micrographic surgery, or radiotherapy.

Conclusions: The impact of KC and its treatment seems relatively low and more positive than negative as patients reported better HRQoL compared to an age- and sex-matched normative population, probably due to adaptation. No statistically significant differences between treatment types were found concerning HRQoL, patient satisfaction, and cosmetic results. This information could be used by healthcare professionals involved in KC care to improve patients' knowledge about different aspects of the disease as patient's preference is an important factor for treatment choice.

Fig. 1

Flowchart of Materials and Methods. Data collection process.

Fig. 2

Differences in cosmetic results between patients who have had one skin cancer (n = 99) and patients who have had multiple skin cancers (n = 108). * p < 0.001.

Fig. 3

Differences on EORTC QLQ-C30 mean functioning and global quality of life (a) and symptom scores (b) between patients with KC (n = 215) and an age- and sex-matched normative population (n = 255). * p < 0.05 and small clinically important difference. Note: a higher score on functioning scores implies a better health-related quality of life, whereas higher symptom scores refer to more symptoms. EORTC QLQ-C30, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30.

Fig. 4

Differences on EORTC QLQ-C30 mean functioning and global quality of life (a) and symptom scores (b) among patients with KC who underwent conventional excision (n = 106), Mohs' micrographic surgery (n = 19), or radiotherapy (n = 55). Note: a higher score on functioning scores implies a better health-related quality of life, whereas higher symptom scores refer to more symptoms. EORTC QLQ-C30, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30.