OUTCOMES ANALYSIS OF VOICE AND QUALITY-OF-LIFE IN PATIENTS WITH LARYNGEAL-CANCER

Objective: To assess relationships between voice satisfaction and glob al quality of life in patients who have been treated for laryngeal can cer. Design: Cross-sectional survey study. Setting: Veterans Affairs M edical Center. Patients: Eighty patients who had completed treat ment for laryngeal cancer with either total laryngectomy (n=17), radiothera py (n=24), or both (n=39). Main Outcome Measures: Subscale scores on a general health status instrument (the Medical Outcomes Study 36-item short-form health survey), and a validated voice-specific functional s tatus instrument (the Voice Handicap Index). Results: Self-rated globa l health did not correlate significantly with emotional, functional, o r physical voice handicap, although some subscales on the 36-item shor t-form health survey correlated with voice handicap scores. Global hea lth status scores did not differ between patients who had undergone la ryngectomy with a tracheoesophageal puncture and patients treated with radiotherapy only. Physical voice handicap scores did not differ sign ificantly between those who underwent tracheoesophageal puncture and t hose who had radiotherapy, but emotional (P=.07) and functional (P=.01 ) handicap scores were lower in patients treated with radiotherapy. Ho wever, there was considerable overlap in voice handicap scores, with m any patients who had had tracheoesophageal puncture showing less voice handicap than patients treated with radiotherapy. Conclusions: These data demonstrate that health status is affected by other factors than voice handicap in patients with laryngeal cancer. In addition, there i s a large amount of individual variation in voice handicap after treat ment. These findings illustrate the need for prospective studies asses sing voice handicap and quality of life after treatment for laryngeal cancer.