Level of distress predicts subsequent survival in successfully treated head and neck cancer patients: a prospective cohort study

Acta Otolaryngol. 2014 Feb;134(2):211-9. doi: 10.3109/00016489.2013.841989. Epub 2013 Nov 21.

Abstract

Conclusion: Our findings indicate a unique survival prediction from general health questionnaire (GHQ) sum scores in successfully treated head and neck squamous cell carcinoma (HNSCC) patients and also to some extent with inclusion of health-related quality of life (HRQoL) scores.

Objective: To examine the survival prediction from the level of distress, measured by GHQ scores obtained from at inclusion successfully treated HNSCC patients.

Methods: Structured interviews were conducted for 135 successfully treated cognitive functioning HNSCC patients 67 ± 31 (mean ± SD) months after diagnosis following a regular follow-up visit. GHQ scores, alcohol consumption history, smoking status, present comorbidities, level of neuroticism, choice of psychological coping with the cancer disease, and HRQoL scores (EORTC QLQ-C30 and -H&N35) were determined. The TNM stage, treatment provided and tumour site were obtained from the hospital records. Forty-three deaths were noted during a minimum 8.5 years of observation.

Results: The GHQ sum scores predicted survival in univariate (p < 0.05) and multivariate analyses with the above-mentioned covariates included (p < 0.01). Using clinically relevant cut-off levels, GHQ scores predicted survival in both univariate (hazard ratio (HR) 1.9; p = 0.05) and multivariate Cox regression analyses (HR 3.8; p = 0.001). We also demonstrated survival prediction from GHQ scores when adjusted by HRQoL scores.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Aged
  • Alcohol Drinking / epidemiology
  • Anxiety Disorders / psychology
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / psychology
  • Carcinoma, Squamous Cell / therapy
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / psychology*
  • Head and Neck Neoplasms / therapy
  • Health Behavior
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neuroticism
  • Personality Inventory
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Quality of Life*
  • Smoking / epidemiology
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires