Patient-reported outcomes in head and neck cancer: a cross-sectional analysis of quality of life domains across early and advanced UICC stages

Allner M, Rak A, Balk M, Rupp R, Almajali O, Tamse H, Gschoßmann J, Sievert M, Müller-Hübner SKU, Koch M, Iro H, Gostian M, Hecht M, Wimmer E, Gostian AO (2025)

Publication Language: English

Publication Type: Journal article

Publication year: 2025

Journal

Supportive Care in Cancer Springer

Book Volume: 33

Article Number: 278

Journal Issue: 4

DOI: 10.1007/s00520-025-09204-3

Abstract

Background: Head and neck cancer (HNC) patients experience a variety of post-treatment symptoms that affect their quality of life (QoL). This study aims to assess the most prevalent symptoms and their relationship to cancer stage (UICC I–IV) while identifying areas for targeted intervention. Methods: A cross-sectional study was conducted involving 340 HNC patients at the University Hospital Erlangen from January to December 2019. QoL and its domains were assessed using the German version of the University of Washington Quality of Life Questionnaire Version 4 (UW-QoL v.4), with comparisons made between early-stage (UICC I & II, n = 180) and advanced-stage (UICC III & IV, n = 160) patients. Statistical analysis examined differences in QoL and its individual domains. Results: Advanced-stage patients reported significantly greater impairments in several QoL domains, including swallowing (p = 0.003, η2 = 0.038), saliva production (p < 0.001, η2 = 0.104), and taste (p = 0.009, η2 = 0.030), compared to early-stage patients. Psychological symptoms, such as anxiety and mood disturbances, were prevalent across all stages, but no significant differences were found between early- and advanced-stage patients for pain, speech, mood, or anxiety (p > 0.05). Patient demographics, including age, gender, and comorbidities, were similar between groups. The greater impairments in QoL domains observed in advanced-stage patients are likely due to more intensive treatments, such as multimodal therapy and radiochemotherapy. Conclusion: Advanced-stage HNC patients experience a significantly higher burden of physical symptoms, particularly issues with swallowing, saliva, and taste, necessitating early and targeted interventions. Psychological issues are also prevalent and should be addressed in both early- and advanced-stage patients. Despite non-significant differences in some symptoms, their clinical relevance may still be important, particularly in individual cases. Comprehensive care, including physical and emotional support, is essential to improving long-term QoL for HNC patients. Further research should focus on longitudinal assessments and clinically meaningful thresholds for symptom management.

Authors with CRIS profile

Moritz Müller Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Atina Rak Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Matthias Balk Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Robin Rupp Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Omar Almajali Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Henriette Tamse Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Juliane Gschoßmann Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Sarina Katrin Ursel Müller-Hübner Lehrstuhl für Hals-Nasen-Ohrenheilkunde Michael Koch Lehrstuhl für Hals-Nasen-Ohrenheilkunde Heinrich Iro Lehrstuhl für Hals-Nasen-Ohrenheilkunde Antoniu-Oreste Gostian

Involved external institutions

Universitätsklinikum des Saarlandes (UKS) DE Germany (DE) Klinikum St. Elisabeth Straubing GmbH DE Germany (DE) Malteser Waldkrankenhaus St. Marien DE Germany (DE)

How to cite

APA:

Allner, M., Rak, A., Balk, M., Rupp, R., Almajali, O., Tamse, H.,... Gostian, A.-O. (2025). Patient-reported outcomes in head and neck cancer: a cross-sectional analysis of quality of life domains across early and advanced UICC stages. Supportive Care in Cancer, 33(4). https://doi.org/10.1007/s00520-025-09204-3

MLA:

Allner, Moritz, et al. "Patient-reported outcomes in head and neck cancer: a cross-sectional analysis of quality of life domains across early and advanced UICC stages." Supportive Care in Cancer 33.4 (2025).

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