{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:54:39Z","timestamp":1791478479093,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>In the setting of similar outcomes, quality of life (QOL) measures can be utilized to compare treatment modalities in head and neck squamous cell carcinoma (HNSCC). We evaluate QOL and symptoms in patients treated for primary, second primary, and recurrent HNSCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Head and neck cancer survivorship clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified patients seen between 2016 and 2019. QOL and symptoms were assessed with the University of Washington Quality of Life (UW\u2010QOL) questionnaire, 10\u2010item Eating Assessment Tool, 8\u2010item Patient Health Questionnaire, 7\u2010item Generalized Anxiety Disorder, and Neck Disability Index. Regression analysis was utilized to explore associations and compare QOL outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our cohort comprised 662 patients: 546 with primary HNSCC, 34 with second primary HNSCC, and 82 with recurrent HNSCC. Multimodality therapy was associated with lower UW\u2010QOL Physical Subscale (UW\u2010QOL\u2010PS) vs single modality: chemoradiation therapy (\u221212.17 [95% CI, \u221216.57 to \u22127.78]) and surgery + postadjuvant treatment (\u221212.11 [\u221216.06 to \u22128.16]). Multimodality therapy was also associated with lower UW\u2010QOL Social\u2010Emotional Subscale (UW\u2010QOL\u2010SS): chemoradiation therapy (\u22126.70 [\u221211.41 to \u22121.99]) and surgery + postadjuvant treatment (\u22127.41 [\u221211.63 to \u22123.19]). Recurrence (\u221214.42 [\u221218.80 to \u221210.04]) and second primary (\u221211.15 [\u221217.71 to \u22124.59]) demonstrated lower UW\u2010QOL\u2010PS vs primary. Radiation for recurrence or second primary had worse UW\u2010QOL\u2010PS (\u221210.43 [\u221219.27 to \u22121.59]) and UW\u2010QOL\u2010SS (\u221210.58 [\u221218.76 to \u22121.54]) and higher Eating Assessment Tool (6.08 [1.39\u201010.77]) than surgery alone. Surgery + postadjuvant treatment showed worse UW\u2010QOL\u2010PS (\u221212.65 [\u221223.76 to \u22121.54]) and UW\u2010QOL\u2010SS (\u221212.20 [\u221222.38 to \u22122.03]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Multimodality therapy, particularly with recurrent and second primary HNSCC, is more likely to contribute to diminished QOL and symptoms. This important consideration should play a role in framing informed discussions with patients regarding treatment.<\/jats:p><\/jats:sec>","DOI":"10.1177\/01945998221087712","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T12:02:03Z","timestamp":1647950523000},"page":"196-202","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Quality of Life in Patients With Recurrent and Second Primary Head and Neck Cancer"],"prefix":"10.1002","volume":"168","author":[{"given":"Vaibhav H.","family":"Ramprasad","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karley","family":"Atchison","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan P.","family":"Zandberg","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Hillman Cancer Center University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Clump","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Hillman Cancer Center University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas T.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marci L.","family":"Nilsen","sequence":"additional","affiliation":[{"name":"Department of Acute and Tertiary Care, School of Nursing University of Pittsburgh  Pittsburgh Pennsylvania 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