This study will evaluate 5-year outcomes in patients with head and neck cancer (HNC) using the Outcomes Assessment Study (OAS), a project initiated in 1995 at the University of Iowa to collect health related quality of life (HRQOL) data in this understudied patient population. The longitudinal protocol of the OAS was originally established to collect HRQOL data through 1-year post-treatment. The data collection time frame will be extended to assess outcomes in long-term (5-year) survivors. The OAS has enrolled over 700 patients; many current and previous OAS participants will be included in this study. The three primary objectives of this longitudinal study center around assessing 5-year HRQOL data pertaining to HNC-specific, general health, and depressive symptomatology outcomes in HNC survivors. The results of this study will be presented in a format that maximizes clinical interpretability by linking HRQOL data to anchor health states familiar to clinicians, and evaluating scores based on clinically significant differences as well as conventional statistical methods. The first objective is to determine the proportion of HNC survivors with poor 5-year HRQOL, and the severity of the deficits within each outcome area. The second objective is to determine the differences between short-term (1 year) and long-term HRQOL outcomes. Determining which 5-year HRQOL outcomes have improved, deteriorated, or remained unchanged will identify the persistent physiologic as well as late effects of treatment. The third objective is to identify the variables that are predictive of positive and negative 5-year HRQOL outcomes. This will also include a determination of the areas of short-term HRQOL that are predictive of long-term HRQOL. Performing these analyses with longitudinal data linking short-term and tong-term outcomes eliminates the biases inherent in comparisons of cross-sectional data. A clear understanding of the long-term physiologic consequences and late effects of HNC treatment will facilitate modification of current treatment regiments and the development of health-care interventions directed at optimizing both long-term outcomes and rehabilitation.
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