TY - JOUR

T1 - Health-Related Quality of Life Following Total Laryngectomy

T2 - A Systematic Review

AU - Wulff, Nille B.

AU - Hojager, Anna

AU - Wessel, Irene

AU - Dalton, Susanne O.

AU - Homoe, Preben

PY - 2021

Y1 - 2021

N2 - ObjectiveTreatment of advanced laryngeal and hypopharyngeal cancer has shifted from total laryngectomy (TL) toward laryngeal‐preserving therapies due to a general perception that TL has a significantly negative impact on the individual's life. However, whether the physical impairments related to TL translate to a reduced health‐related quality of life (HRQoL) has not yet been determined. Therefore, the objective of this systematic review was to determine how HRQoL is affected following TL.MethodsSystematic searches were conducted in PubMed, Embase, and Cochrane. Inclusion criteria were original studies describing quality of life following TL after larynx/hypopharynx cancer using a formally developed patient‐reported questionnaire. Study quality assessment was carried out with the tool developed by the National Heart, Lung, and Blood Institute.ResultsForty‐six studies using 12 different questionnaires were included. The majority were cross‐sectional (85%), and study quality was rated poor in 30%, fair in 30%, and good in 39% of studies. When comparing results from the four most frequently used questionnaires with normative data, we found that in more than 60% of studies, differences to the reference population were of clinical importance, with only few exceptions.ConclusionsIn general, we found that people who received TL have a worse HRQoL than the male normative reference population. However, even though TL patients experience a clinically important difference in many domains when compared with normative data, their burden of symptoms is generally mild. The current review also makes it evident that despite the relatively large number of studies conducted, the strength of evidence remains weak. Laryngoscope, 2020

AB - ObjectiveTreatment of advanced laryngeal and hypopharyngeal cancer has shifted from total laryngectomy (TL) toward laryngeal‐preserving therapies due to a general perception that TL has a significantly negative impact on the individual's life. However, whether the physical impairments related to TL translate to a reduced health‐related quality of life (HRQoL) has not yet been determined. Therefore, the objective of this systematic review was to determine how HRQoL is affected following TL.MethodsSystematic searches were conducted in PubMed, Embase, and Cochrane. Inclusion criteria were original studies describing quality of life following TL after larynx/hypopharynx cancer using a formally developed patient‐reported questionnaire. Study quality assessment was carried out with the tool developed by the National Heart, Lung, and Blood Institute.ResultsForty‐six studies using 12 different questionnaires were included. The majority were cross‐sectional (85%), and study quality was rated poor in 30%, fair in 30%, and good in 39% of studies. When comparing results from the four most frequently used questionnaires with normative data, we found that in more than 60% of studies, differences to the reference population were of clinical importance, with only few exceptions.ConclusionsIn general, we found that people who received TL have a worse HRQoL than the male normative reference population. However, even though TL patients experience a clinically important difference in many domains when compared with normative data, their burden of symptoms is generally mild. The current review also makes it evident that despite the relatively large number of studies conducted, the strength of evidence remains weak. Laryngoscope, 2020

KW - Quality of life

KW - total laryngectomy

KW - systematic review

U2 - 10.1002/lary.29027

DO - 10.1002/lary.29027

M3 - Review

C2 - 32866284

VL - 131

SP - 820

EP - 831

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

IS - 4

ER -