Functional and cognitive impairment , depressive symptoms and social isolation are highly prevalent in head and neck cancer patients and associate with high risk of adverse health outcomes .
OBJECTIVES Older head and neck cancer patients are at increased risk for adverse health outcomes , but little is known about which geriatric assessment associates with poor outcome .
The aim is to study the association of functional or cognitive impairment , social environment and frailty with adverse health outcomes in patients with head and neck cancer .
Quality of life scores as prognostic factors of overall survival in advanced head and neck cancer: analysis of a phase III randomized trial of pemetrexed plus cisplatin versus cisplatin monotherapy.
OBJECTIVES We examined the prognostic factors ( clinical , demographic , and health-related quality of life [ HRQoL ] ) of overall survival ( OS ) and progression-free survival ( PFS ) in patients with recurrent/metastatic head and neck cancer ( HNC ) who were treated with pemetrexed plus cisplatin versus cisplatin in a phase III , multinational , r and omized trial . MATERIAL S AND METHODS Five subscales of the Functional Assessment of Cancer Therapy-Head and Neck Cancer ( FACT-H&N ) , modified to score from 0 to 100 , measured HRQoL at baseline and during treatment . Univariate and multivariate Cox proportional hazards models were used on data pooled from both treatment arms to assess the effect of baseline prognostic factors on OS and PFS . RESULTS Of 795 patients r and omized , 704 completed a baseline FACT-H&N and were included in the analysis . Age ( < 65 versus ⩾65 ; HR=0.74 , 95 % CI : 0.61 - 0.90 ) , race ( Caucasian versus non-Caucasian ; HR=0.83 , 95 % CI : 0.70 - 0.98 per table ) , Eastern Cooperative Oncology Group performance status ( ECOG PS ; 0/1 versus 2 ; HR=0.44 , 95 % CI : 0.35 - 0.56 ) , prior surgery/radiotherapy in the last 6months ( no versus yes ; HR=0.74 , 95 % CI : 0.61 - 0.90 ) , and primary site of disease ( oral cavity versus other ; HR=1.37 , 95 % CI : 1.15 - 1.63 ) were significantly prognostic of OS in univariate models , as were baseline scores on four FACT-H&N subscales ( physical well-being , emotional well-being , functional well-being , additional concerns-H&N ; HRs=0.82 - 0.94 ; all P⩽0.002 ) . In multivariate models , significant prognostic factors were age ( HR=0.78 ) ; race ( HR=0.76 per table ) ; ECOG PS ( HR=0.56 ) ; prior surgery/radiotherapy ( HR=0.76 ) ; and baseline scores of the FACT-H&N subscales of physical well-being , social/family well-being , and additional concerns-H&N ( HRs=0.89 - 0.94 ; all P⩽0.014 per table ) . CONCLUSIONS The results suggest that baseline HRQoL scores are prognostic indicators of OS in recurrent/metastatic HNC in addition to other known clinical and demographic indicators . HRQoL might be considered as a stratification factor in r and omized clinical trials of recurrent/metastatic HNC
Functional and cognitive impairment , depressive symptoms and social isolation are highly prevalent in head and neck cancer patients and associate with high risk of adverse health outcomes .
OBJECTIVES Older head and neck cancer patients are at increased risk for adverse health outcomes , but little is known about which geriatric assessment associates with poor outcome .
The aim is to study the association of functional or cognitive impairment , social environment and frailty with adverse health outcomes in patients with head and neck cancer .