Investigation of QOL after Laryngectomy Using the UW-QOL Questionnaire with Chinese Patients

摘要

OBJECTIVE To assess the postoperative QOL(Quality of Life) of Chinese laryngeal cancer patients who have undergone a partial or total laryngectomy, and to analyze their prognostic factors, as well as to assess the feasibility of using the University of Washington Quality of Life (UW-QOL) questionnaire in QOL studies of laryngeal cancer patients. METHODS Using the UW-QOL questionnaire, a survey was conducted in patients treated by a partial or total laryngectomy for laryngeal cancer. RESULTS Questionnaires were sent to 142 patients who were disease-free for more than half a year after surgery. Replies were received from 130 patients (91% response rate) with 118 patients completing the questionnaire. These patients were divided into 2 groups: a partial-laryngectomy group (n = 81; excluding cordectomy) and a total -laryngectomy group (n = 37). The composite QOL scores of the partial-laryngectomy group (692.3 ± 127.9) were higher than those of total-laryngectomy group (636.4 ± 140.0), showing a statistically significant difference (P < 0.05). The partial-laryngectomy group (74.3 ± 23.8; 80.9 ± 20.3) was better than the total-laryngectomy group (40.3 ± 25.8; 69.6 ± 27.1) in speech and appearance (P < 0.001; P < 0.05); but the total-laryngectomy group (92.6 ± 13.0) was superior to the partial-laryngectomy group (83.0 ± 20.5) in pain (P < 0.01). Six factors including cancer stage, operative modality, complications, postoperative radiotherapy or chemotherapy, living partners and chronic disease before or after operation were related to postlaryngecto-my QOL. CONCLUSION Partial laryngectomy is superior to total laryngectomy in speech, appearance and overall QOL. Besides operative modality, cancer stage, complications, postoperative radiotherapy or chemotherapy, living partners and chronic diseases before or after operation are factors influencing postlaryngectomy QOL. As a whole, the UW-QOL questionnaire is a good instrument for studying QOL of laryngeal cancer patients in China, and it can be used to explore the QOL outcomes obtained from different reconstructive techniques.