Sociodemographic factors and quality of life as prognostic indicators in head and neck cancer

Pre-treatment quality of life (QOL) has been found to be an independent pro gnostic factor for survival in cancer patients, in particular in patients w ith advanced cancer. Sociodemographic factors such as marital and socioecon omic status have also been recognised as prognostic factors. We studied the influence of QOL and mood (measured with the European Organization for Res earch and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30) and the He ad and Neck Cancer Questionnaire (EORTC QLQ-H&N35), and with the Center for Epidemiologic Studies-Depression Scale (CES-D)) as measured before treatme nt, the use of cigarettes and alcohol and sociodemographic Factors (age, ge nder, marital status, income and occupation) on recurrence and survival in 208 patients with head and neck cancer prior to treatment with surgery and/ or radiotherapy. using Kaplan-Meier and Cox regression analyses. Cognitive functioning and, to a lesser degree, marital status were independent predic tors of recurrence and survival, along with medical factors (stage and radi cality). Patients with less than optimal cognitive functioning and unmarrie d patients had a relative risk (RR) of recurrence of 1.72 (95% confidence i nterval (95% Ct) 1.01-2.93) and 1.85 (95% CI 1.06-3.33), respectively, and a RR of dying of 1.90 (95% CI 1.10-3.26) and 1.82 (95% CI 1.03-3.23), respe ctively. Performance status, physical functioning, mood and global QOL and smoking and drinking did not predict for recurrence and survival. The influ ence of cognitive functioning might be related to the use of alcohol. Marit al status may influence prognosis through mechanisms of health behaviour an d/or social support mechanisms. (C) 2001 Elsevier Science Ltd. All rights r eserved.