Psychosocial and physical correlates of survival and recurrence in patients with head and neck carcinoma Results of a 6-year longitudinal study

Abstract

Studies that have examined correlations between psychosocial factors and survival in cancer patients do not permit any definitive conclusions. To the authors’ knowledge, no study to date has examined the relation between medical as well as quality of life variables and survival in head and neck carcinoma patients. The current study focused on the complex interactions between psychosocial, medical, behavioral and demographic variables as they relate to prognosis in these patients. A total of 133 consecutive head and neck carcinoma patients were included in a prospective study at pretreatment. In addition to clinical variables, psychosocial and physical functioning were assessed by means of a self‐report questionnaire. During the observation period, 57 patients died, whereas 76 were still alive at 6 years after treatment. Results of the multivariate survival analysis indicated that patients without head and neck metastasis had a better prognosis than patients with positive cervical lymph nodes. Pretreatment smoking showed a negative correlation with overall survival. Patients who were more physically self‐efficacious (i.e. higher perceived physical abilities) were more likely to survive and less likely to develop a recurrence. In addition, patients who expressed intense psychosocial complaints prior to treatment had a better prognosis than had those who did not express such negative feelings. The current findings linking physical self‐efficacy and prognosis are promising, but clinical trials are necessary to examine the direct and indirect mediational pathways of the variables that underlie physical efficacy and influence survival and recurrence. Also, the negative correlation between pretreatment smoking and survival suggests a need for increased efforts to address smoking in newly diagnosed patients. H. Tideman

Goal processes & self-efficacy related to psychological distress in head & neck cancer patients and their partners

“…It has been stated that such a confidence is a prerequisite for actual performance of adaptive self-regulatory strategies (Clark and Dodge, 1999). Self-efficacy has been found to play a central role in psychological well-being in patients with different chronic illnesses (Kuijer and De Ridder, 2003;De Boer et al, 1998). Also among H&N cancer patients with facial disfigurement, self-efficacy appeared to be an important asset in controlling psychological distress (Hagedoorn and Molleman, 2006).…”

Identification and interpretation of clinical and quality of life prognostic factors for survival and response to treatment in first-line chemotherapy in advanced breast cancer

“…This ®nding is potentially important for the design of studies, particularly those involving palliative therapies. Studies using linear analogue self-assessment (LASA) scales [3±5], the Functional Living Index in Cancer (FLIC) [6,7], the Therapy Impact Questionnaire (TIQ) [8,9], the Rotterdam Symptom Checklist [10,11] and other instruments [12,13] have suggested that many QL variables might have prognostic importance.…”

An information system to support the care for head and neck cancer patients

“…We use validated questionnaires [6,7] for QOL parameters such as uncertainty, feelings of depression, anxiety, and physical complaints. To determine use, all user actions are stored in a log file.…”