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American Head & Neck Society
July 21-25, 2012
Metro Toronto Convention Centre
Toronto, ON, Canada


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CONSTRUCTING THE MONTREAL HEAD AND NECK SCORE TO PREDICT QUALITY OF LIFE OUTCOMES IN ORAL AND OROPHARYNGEAL CANCER

Presentation: P076
Topic: Larynx/Oral Cavity
Type: Poster
Date: Sunday - Tuesday, July 22 - 24, 2012
Session: Designated Poster viewing times
Authors: Sami P Moubayed, MD, John S Sampalis, PhD, Tareck Ayad, MD, Louis Guertin, MD, Jean-Claude Tabet, MD, Phuc-Felix Nguyen-Tan, MD, Edith Filion, MD, Louise Lambert, MD, Denis Soulières, MD, Apostolos Christopoulos, MD MSc
Institution(s): Centre Hospitalier de l'Université de Montréal (CHUM)

BACKGROUND: The main application of quality of life (QOL) assessment in oral and oropharyngeal cancer is to facilitate treatment selection. Previously published prospective studies suggest that QOL of these patients stabilizes 12 months after diagnosis. Many validated instruments have been developed for the evaluation of QOL, although their routine use is limited due to time and resource constraints. Therefore, a clinical rule for prediction of long-term QOL in oral and oropharyngeal cancer is a necessity for efficient QOL assessment. However, no such rule exists at the moment. Clinical prediction rules are constructed using significant predictors. However, data is scarce and studies are conducted on small cohorts and do not evaluate head and neck cancer patients by subsite.

HYPOTHESES: (1) The following factors are predictive of QOL in oral and oropharyngeal cancer: comorbidities, age, sex, depression, stage, malnutrition, HPV status, chemotherapy, neck dissection, radiotherapy, multimodality treatment, extensive surgery, pedicled flap reconstruction. (2) Using the most significant predictors, a clinical prediction rule of QOL can be developed.

OBJECTIVES: (1) To identify significant predictive factors of QOL in oral and oropharyngeal cancer. (2) To develop a clinical rule predictive of poor QOL in this population.

METHODS: (1) A historical cohort study will be conducted on oral and oropharyngeal cancer patients at least 12 months after diagnosis. We require 156 patients with oral cavity and oropharyngeal cancer according to sample size calculations. We will evaluate QOL using three validated questionnaires: EORTC QLQ-C30, EORTC QLQ-HN35, and HADS. HPV status will be evaluated using PCR on tissue samples. The following factors will be evaluated: site, sub-site, TNM classification, stage, comorbidities, age, sex, pretreatment depression, malnutrition, neutrophil count, hemoglobin, treatment type, locoregional, specific, and global survival. Bivariate analyses will identify long-term predictors of QOL and symptoms of anxiety and depression (t test, ANOVA, Pearson’s correlation coefficient). Multivariate linear regression will identify the factors with independent significance. (2) Using the most significant predictors of QOL, we will develop a clinical prediction rule for long-term QOL

RESULTS AND CONCLUSIONS: We expect to identify several significant predictors of long-term QOL in oral and oropharyngeal cancer. This is the first study in the literature to evaluate the impact of HPV status on QOL in head and neck cancer. This is one the first studies to evaluate QOL in head and neck cancer according to sub-site. This is the first attempt in the literature at prediction score development for head and neck cancer. This study can potentially generate economies in costs related to QOL assessment as it will predict QOL using significant predictive factors instead of lengthy self-administered questionnaires.

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