QUALITY-OF-LIFE AFTER SURGICAL-TREATMENT OF CANCER OF THE LARYNX

The purpose of the study was to assess the quality of life of patients after surgical treatment for cancer of the larynx. Three groups of pa tients were identified according to surgical treatment: total laryngec tomy, 111 patients; near-total laryngectomy, 38 patients; and partial laryngectomy, 23 patients. The impact of successful surgical treatment on their life roles was analyzed in terms of work, activities, famili al and spousal relationships, sexuality, and psychologic features such as stress and anxiety. Two questionnaires were used: the Psychosocial Adjustment to Illness Scale (PAIS) and the Mayo Clinic Postlaryngecto my Questionnaire. With the PAIS questionnaire, no difference was found in role adjustment between the total laryngectomy and near-total lary ngectomy groups, with one exception. In the work domain, the total lar yngectomy patients who were working had better adjustment than the nea r-total laryngectomy patients. The overall adjustment of both groups w as less favorable than that of a comparison group of patients with non laryngeal cancer. The patients who had the classic conservation operat ions adjusted in all domains more favorably than the patients with per manent tracheostomas. The partial operation patients adjusted better t han the nonlaryngeal cancer patients. We conclude that the stoma has a negative impact on adjustment postoperatively and that it may have a more serious impact on life adjustment than voice alteration. Further investigation and standardization of measurement tools are needed.