Prospective quality of life outcomes for human papillomavirus associated oropharynx cancer patients after surgery alone.

May 22, 2023

Experts: Erika M Stephens,Karolina Plonowska-Hirschfeld,Arushi Gulati,Sagar Kansara,Jesse Qualliotine,Aaron L Zelbolsky,Annemieke van Zante,Patrick K Ha,Chase M Heaton,William R Ryan

To evaluate changes in patient-reported quality of life (QOL) to inform treatment decisions for human papillomavirus-associated oropharynx squamous cell carcinoma (HPV + OPSCC).
Patients with American Joint Committee on Cancer (AJCC) 8th edition cT0-T3 and cN0-N3 HPV + OPSCC treated with transoral robotic surgery to the primary site with neck dissection completed questionnaires prior to surgery and at three-months and one-year post-operatively. Questionnaires included four validated instruments: the University of Washington Quality of Life Questionnaire (UW-QOL), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and Head and Neck Module (HN35), and the Neck Dissection Impairment Index (NDII).
Forty-eight patients filled out pretreatment and three-month questionnaires. 37 patients filled out one-year questionnaires. With the UW-QOL, at three-months, patients reported a statistically significant and clinically meaningful decreased mean score for appearance that resolved at one-year (presurgery: 92.4, 3-month: 81.0, p < 0.001; one year: 86.5). At three months and one-year, significant and clinically meaningful decreased mean taste scores persisted (presurgery: 98.0; three-months: 76.3, one-year: 80.3; all p < 0.001). With the EORTC QLQ-C30 and HN35, at one-year, only mean scores for sense of taste or smell (one-year: 13.1; p < 0.001) did not return to baseline. With the NDII, patients returned to functions comparable to baseline in all domains.
Post-treatment quality of life is high for HPV+ OPSCC patients treated with surgery alone. Mild taste and possibly smell dysfunction may continue in some patients. With careful selection, surgery alone for HPV + OPSCC offers favorable QOL outcomes.
Patients with HPV+ associated oropharynx cancer treated with surgery alone completed quality of life questionnaires before and after surgery. Quality of life remained high for most patients, with a subset of patients experiencing mild taste dysfunction one-year after surgery.

Copyright © 2023 Elsevier Inc. All rights reserved.

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ABOUT THE EXPERTS

Erika M Stephens,Karolina Plonowska-Hirschfeld,Arushi Gulati,Sagar Kansara,Jesse Qualliotine,Aaron L Zelbolsky,Annemieke van Zante,Patrick K Ha,Chase M Heaton,William R Ryan

Erika M Stephens

School of Medicine, University of California-San Francisco, San Francisco, CA, United States of America.

Karolina Plonowska-Hirschfeld

Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, United States of America.

Arushi Gulati

School of Medicine, University of California-San Francisco, San Francisco, CA, United States of America.

Sagar Kansara

Our Lady of the Lake Head and Neck Center, Our Lady of the Lake Regional Medical Center, 4950 Essen Ln, Suite 400, Baton Rouge, LA, United States of America.

Jesse Qualliotine

Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, United States of America.

Aaron L Zelbolsky

Department of Otolaryngology – Head and Neck Surgery, University of Tennessee-Memphis, Memphis, TN, United States of America.

Annemieke van Zante

Department of Pathology, University of California-San Francisco, San Francisco, CA, United States of America.

Patrick K Ha

Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, United States of America.

Chase M Heaton

Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, United States of America.

William R Ryan

Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA, United States of America. Electronic address: william.ryan@ucsf.edu.