{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:08:40Z","timestamp":1785323320372,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,1,15]],"date-time":"2019-01-15T00:00:00Z","timestamp":1547510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["5T32DC000066"],"award-info":[{"award-number":["5T32DC000066"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>With the intensification and utilization of multimodal treatment, acute toxicities have increased; however, the frequency of treatment sequelae in long\u2010term head and neck cancer (HNC) survivors are poorly described. The purpose of this analysis was to determine the prevalence and predictors of patient\u2010reported late and long\u2010term treatment\u2010related sequelae in HNC survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a cross\u2010sectional analysis of patient\u2010reported outcomes from 228 survivors attending a multidisciplinary HNC survivorship clinic. The primary outcomes comprised quality of life (QOL), symptoms of anxiety and depression, and swallowing dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Male gender, tumor sites in the oropharynx and larynx, longer time since treatment, and treatment with surgery alone were associated with higher physical QOL (<jats:italic>P<\/jats:italic> &lt; .05). Male gender, longer time since treatment, and treatment with surgery alone were associated with higher social\u2010emotional QOL (<jats:italic>P<\/jats:italic> &lt; .05). A reduction in anxiety symptoms and a higher QOL were related to longer time since treatment; however, a reduction in swallowing dysfunction symptoms was only related to longer time since treatment until approximately 6 years. After 6 years, survivors reported worse swallowing dysfunction (<jats:italic>P<\/jats:italic> &lt; .05). One hundred thirty\u2010two survivors (56%) reported at least three treatment\u2010related effects that impacted their daily life. Finally, advanced stage disease at diagnosis (stage III\u2013IV) was also associated with severe swallowing dysfunction (<jats:italic>P<\/jats:italic> = .004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These data indicate the remarkable prevalence of treatment\u2010related effects in HNC survivors. These results highlight the need for de\u2010intensification of therapies, where appropriate, and for a better understanding of pathophysiology and new approaches to mitigating treatment effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 129:E437\u2013E444, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27801","type":"journal-article","created":{"date-parts":[[2019,1,16]],"date-time":"2019-01-16T08:00:35Z","timestamp":1547625635000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Burden of treatment: Reported outcomes in a head and neck cancer survivorship clinic"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5888-668X","authenticated-orcid":false,"given":"Marci Lee","family":"Nilsen","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh, School of 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