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Changing functional status within 6 months posttreatment is prognostic of overall survival in patients with head and neck cancer: NRG Oncology Study
Author(s) -
Eldridge Ronald C.,
Pugh Stephanie L.,
Trotti Andy,
Hu Kenneth,
Spencer Sharon,
Yom Sue S.,
Rosenthal David,
Read Nancy,
Desai Anand,
Gore Elizabeth,
Shenouda George,
Mishra Mark V.,
Bruner Deborah,
Xiao Canhua
Publication year - 2019
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25922
Subject(s) - medicine , head and neck cancer , hazard ratio , confidence interval , proportional hazards model , oncology , cancer , clinical trial
Background Is posttreatment functional status prognostic of overall survival in patients with head and neck cancer (HNC). Methods In an HNC clinical trial, 495 patients had two posttreatment functional assessments measuring diet, public eating, and speech within 6 months. Patients were grouped by impairment (highly, moderately, modestly, or not impaired) and determined if they improved, declined, or did not change from the first assessment to the second. Multivariable Cox models estimated overall mortality. Results Across all three scales, the change in posttreatment patient function strongly predicted overall survival. In diet, patients who declined to highly impaired had three times the mortality of patients who were not impaired at both assessments (hazard ratio [HR] = 3.60; 95% confidence interval, 2.02‐6.42). For patients improving from highly impaired, mortality was statistically similar to patients with no impairment (HR = 1.38; 95% CI, 0.82‐2.31). Conclusions Posttreatment functional status is a strong prognostic marker of survival in patients with HNC.