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UW-QOL modified questionnaire in which it is included a newly diagnosed HNSCC. They used QLQ-C30 and QLQ-
new item called overall well-being. Results showed that h&N35 questionnaires in a group of 106 patients, finding that
scores for all parameters were higher or at least equally high comorbidity is a risk factor especially cardiac disease.
high for group 2 compared to group 1. When asked They did not find relation between tumour stage and tumour
to compare their pre- and post-therapeutic HRQOL, location, and, alcohol consumption supposes a predictive
21.9% of patients in group 1 stated that there were no value of survival. [45]
differences, whereas 46.9% stated there was a moderate
deterioration, and 31.3% stated that deterioration CONCLUSION
was marked. Furthermore, 53.1% of patients in group
2 and 56.3% of patients in group 3 reported a marked Over the last decades, the perspective and management of
deterioration of their QOL after treatment. In fact, just SCC in head and neck has changed, many disciplines have
34,4% in group 2 and 53.1% in group 3 would consent to contributed to improve the prognosis not only surgeons.
further RT/CMT if necessary during the follow up. [39] The advancement of reconstructive surgical techniques
and adjuvant therapies such as RT/CMT made treatable an
Herce-Lopez et al. elaborated a cross-sectional study increased number of patients with many risk factors that
[40]
including 60 patients treated for a head and neck cancer otherwise would have been relegated to palliative care.
who survived over 5 years without recurrences. In this
case, patients filled out the SF-36 questionnaire, which Regarding SCC prognosis, many factors have demonstrated
include 8 categories: physical functioning, role-physical, to be influential but, high level tumour stage and short length
role-emotional, vitality, mental health, social function, pain of free survival disease time are the most important to predict
and the social dimension. Regarding the impact of gender, the really expectation of therapies.
in the male group, found statistically significant positive
differences for the dimensions of vitality and general health; Despite de numerous studies published in the literature about
and significantly negative for the dimensions of role-physical, the assessment of the quality of life in patients with HNSCC,
social functioning and pain. In the female group, statistically the heterogeneity of the population and the lack of internal
significant negative differences for the dimensions social validity of studies, can explain why there is not a consensus
functioning were observed. Respecting age, patients over about the accuracy of the questionnaires as a predictive tool
65 years showed statistically significant negative differences to distinguish the bad prognosis cases and their capacity to
for social functioning and pain; and positive for vitality and choose the best therapeutic option in every situation.
general health status. Similar to previous results, T1-T2 stages
had significant positive differences for general health and Currently, data do not let us individualize patients’ treatment,
negative for role-physical, role-emotional, social functioning but this is the objective for the future and maybe new studies
and paint. Also, T3-T4 showed statistically negative will show us the ways to identify how the QOL can modify the
differences for social functioning and pain. The impact of treatment choices.
surgical reconstruction showed that patients who underwent
complex reconstruction referred worse social functioning Financial support and sponsorship
and pain, whereas patients who did not receive this kind of Nil.
surgical procedure they referred a better general health status
unless worst role-physical, role-emotional, social functioning Conflicts of interest
and pain. [40] There are no conflicts of interest.

Follow up length is still a controversial aspect, because every REFERENCES
author obtained results according a short follow-up period.
Nevertheless, Rogers et al. determined no differences 1. Machiels JP, Lambrecht M, Hanin FX, Duprez T, Gregoire V, Schmitz S,
[41]
respecting the QOL between patients after 1 year of Hamoir M. Advances in the management of squamous cell carcinoma of
treatment or 5 years. Although, other authors are not agree the head and neck. F1000Prime Rep 2014;6:44.
with this because patients consider themselves cured 5 years 2. Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tân PF,
after treatment may significantly change their perception of Westra WH, Chung CH, Jordan RC, Lu C, Kim H, Axelrod R, Silverman
CC, Redmond KP, Gillison ML. Human papillomavirus and survival of
the disease. patients with oropharyngeal cancer. N Engl J Med 2010;363:24-35.
3. Gillison ML. Human papillomavirus-associated head and neck cancer
With regard to survival prediction from pre-treatment is a distinct epidemiologic, clinical, and molecular entity. Semin Oncol
HRQOL data among HNSCC patients, few investigations 4. 2004;31:744-54.
Johnson-Obaseki S, McDonald JT, Corsten M, Rourke R. Head and neck
with some extent of varied finding have been published. cancer in Canada: trends 1992 to 2007. Otolaryngol Head Neck Surg
A significant predictive effect of HRQOL scores on survival 2012;147:74-8.
has been detected, but noteworthy variations with regard 5. Checcoli E, Bianchini C, Ciorba A, Candiani M, Riberti C, Pelucchi S,
to design, simple sizes, and use of HRQOL inventories Pastore A. Reconstructive head and neck surgery: oncological and
exist. [42-44] Osthus et al. determined the predictive potential 6. functional results. Tumori 2013; 99:493-9.
[45]
Gregoire V, Lefebvre JL, Licitra L, Felip E; EHNS-ESMO-ESTRO
of HQROL scores in a heterogeneous cohort of patients with Guidelines Working Group. Squamous cell carcinoma of the head and
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