Factors affecting the quality of life and outcome after surgical treatment of cancer of the head and neck area
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Oulu University Hospital, lecture hall 5
Topic of the dissertation
Factors affecting the quality of life and outcome after surgical treatment of cancer of the head and neck area
Doctoral candidate
MD Krisztina Molnár
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Anesthesiology and intensive care research unit
Subject of study
Anesthesiology and intensive care
Opponent
docent Minna Niskanen, Kuopio University Hospital
Custos
professor Janne Liisanantti, Oulu University Hospital
Factors affecting the quality of life and outcome after surgical treatment of cancer of the head and neck area
Ablative surgery is the cornerstone of the treatment of cancers of the head and neck area. The quality of life (QoL) of patients with head and neck cancers has been studied quite well, but evaluating the effect of different procedures on QoL and psychological well-being, is not well studied.
The aim of this thesis is to evaluate long-term QoL after neck dissection and free flap surgery and investigate regional differences in the surgical treatment of head and neck cancer. This study consists of both retrospective and prospective questionnaire studies, and the studies included head and neck cancer patients operated on at Oulu University Hospital between 2013 and 2019.
The measured QoL was significantly lower at 5 years after free flap surgery compared to assessment conducted 2 years after the operation, and at 5 years, the measured QoL was lower compared to the Finnish general population. Similar results were found after neck dissection; on average 4.5 years after the operation, the QoL of the patients was significantly worse compared to general population. Deterioration in QoL after both surgeries was mostly due to psychosocial factors and depression. Patient- or operation-related factors did not have an impact on the QoL. Moreover, it was found that poor QoL measured 2 years after free flap surgery was associated with higher long-term mortality in this patient group. There were significant differences in the utilization of surgical treatment for cancers of the head and neck area within the hospital district; the rate of ablative surgery was higher in population living in rural and low-income areas. In these areas, the required operations were larger due to more advanced disease and the long-term mortality was higher compared to patients from urban and high-income areas.
In conclusion, the rate of ablative surgery and mortality for head and neck cancer is higher in rural and low-income areas. The patients’ QoL deteriorated during the 5-year follow-up after surgery, primarily related to psychological well-being, and poor QoL is associated with higher long-term mortality.
The aim of this thesis is to evaluate long-term QoL after neck dissection and free flap surgery and investigate regional differences in the surgical treatment of head and neck cancer. This study consists of both retrospective and prospective questionnaire studies, and the studies included head and neck cancer patients operated on at Oulu University Hospital between 2013 and 2019.
The measured QoL was significantly lower at 5 years after free flap surgery compared to assessment conducted 2 years after the operation, and at 5 years, the measured QoL was lower compared to the Finnish general population. Similar results were found after neck dissection; on average 4.5 years after the operation, the QoL of the patients was significantly worse compared to general population. Deterioration in QoL after both surgeries was mostly due to psychosocial factors and depression. Patient- or operation-related factors did not have an impact on the QoL. Moreover, it was found that poor QoL measured 2 years after free flap surgery was associated with higher long-term mortality in this patient group. There were significant differences in the utilization of surgical treatment for cancers of the head and neck area within the hospital district; the rate of ablative surgery was higher in population living in rural and low-income areas. In these areas, the required operations were larger due to more advanced disease and the long-term mortality was higher compared to patients from urban and high-income areas.
In conclusion, the rate of ablative surgery and mortality for head and neck cancer is higher in rural and low-income areas. The patients’ QoL deteriorated during the 5-year follow-up after surgery, primarily related to psychological well-being, and poor QoL is associated with higher long-term mortality.
Last updated: 29.11.2024