974 Table 1. General characteristics of laryngeal cancer patients Characteristics Total laryngectomy Conservative surgery erapy Radioth- Overall Mean

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1 KISEP Head and Neck Korean J Otolaryngol 2001;44: 후두암치료후삶의질평가 남성일 송달원 안병훈 최동하 손진식 Quality of Life after Treatment of Laryngeal Carcinoma Sung Il Nam, MD, Dal Won Song, MD, Byung Hoon Ahn, MD, Dong Ha Choi, MD and Jin Sik Sohn, MD Department of Otolaryngology, School of Medicine, Keimyung University, Taegu, Korea ABSTRACT Background and Objectives:Head and neck cancer strikes at some of the most basic human functions, including verbal communication, social interaction, eating and breathing. Traditionally, the success of cancer treatment has been assessed by objective measures such as disease-free intervals, cure rates, and complication rates. Recently, however, there has been an increased awareness of the need to evaluate treatment effects on the individual s quality of life (QOL). The purpose of this study is to assess quality of life following various types of treatment for laryngeal carcinoma. Material and Methods:We assessed a quality-of-life after treatment of laryngeal carcinoma patients using WHOQOL-BREF questionnaires which was employed by the WHOQOL-group. Fifty-seven patients with laryngeal carcinoma were contacted with the completion of the survey:radiotherapy only (n=24), conservative laryngectomy (n=16) and total layngectomy (n=17). Results:This study demonstrates that there was no significant difference in QOL in physical health, social relationship and environment between the radiotherapy-only-group and the operation-group (conservative & total laryngectomy). However, the radiotherapy-only group had significantly better (p<.05) QOL on the psychological health domain, especially regarding body image and negative feelings than those of the operation group. Conclusion:The negative feeling, the body image change and the poor ability of communication have a negative impact on QOL in the operation group, especially in the total laryngectomee. Providing positive psychosocial adjustment training and voice rehabilitation programs for those who underwent total laryngectomy would be a great help in enhancing their quality of life. Korean J Otolaryngol 2001;44: KEY WORDS:Quality of life Larynx Carcinoma WHOQOL-BREF. 973

2 974 Table 1. General characteristics of laryngeal cancer patients Characteristics Total laryngectomy Conservative surgery erapy Radioth- Overall Mean age, Yr No. of patients Level of education High school High school High school Living arrangement living alone Economic statusmonthly income won Table 2. WHOQOL-BREF domains of QOL Domain Facets incorporated within domains I. Physical health Pain and discomfort item 11 Sleep and rest item 23 Energy and fatigue item 18 Mobility item 33 Activities of daily living item 24 Dependence on medication item 12 Work capacity item 25 II. Psychological Positive feeling item 13 Thinking, learning, memory item 15 Self-esteem item 26 Body image and appearance item 19 Negative feelings item 34 Spirituality/religion item 14 III. Social relation- Personal relationships item 27 ships Social support item 29 Sexual activity item 28 IV. Environment Freedom, physical safety item 16 Home environment item 30 Financial resources item 20 Health and social care item 31 Information item 21 Recreation leisure activity item 22 Physical environment item 17 Transport item 32 Korean J Otolaryngol 2001;44:973-81

3 Fig. 1. Comparison of health related quality of life for patients with laryngeal cancer vs. control group. Domain 1 Indicates physical health, Domain 2Psychological health, Domain 3Social relationship, Domain 4Environment p0.05. Fig. 3. Comparison of health related quality of life for operation group total laryngectomy and conservationlaryngectomy vs. radiation therapy. Domain 1Indicates physical health, Domain 2Psychological health, Domain 3Social relationship, Domain 4Environment p0.05. Fig. 2. Comparison of health related quality of life for total laryngectomy vs. conservation surgery vs. radiation therapy. Domain 1Indicates physical health, Domain 2Psychological health, Domain 3Social relationship, Domain 4Environment p0.05. Fig. 4. Comparison of health related quality of life for total laryngectomy vs. conservative laryngectomy and radiation therapy. Domain 1Indicates physical health, Domain 2 Psychological health, Domain 3Social relationship, Domain 4Environment p

4 Table 3. Problems of swallowing For swallowing 976 Total Conservation Radiation laryngectomy surgery therapy Generally possible Difficult 1 1 Greatly difficult Fig. 5. Comparison of voice and quality of life for total laryngectomy vs. conservative laryngectomy vs. radiation therapy. Korean J Otolaryngol 2001;44:973-81

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6 REFERENCES 1) Song DW, Kim HJ, Jeong HS, Kim YH, Ahn JH, Lee BS, et al. Treatment result in laryngeal cancer patient submitted to surgical treatment. Korean J Otolaryngol 1999;42: ) Stewart MG, Chen AY, Stach CB. Outcomes analysis of voice and quality of life in patients with larygeal cancer. Arch Otolaryngol Head Neck Surg 1998;124: ) Otto RA, Dobie RA, Lawrence V, Sakai C. Impact of a Laryngectomy on quality of life: Perspective of the patient versus that of the health care provider. Ann Otol Rhinol Laryngol 1997;106: ) Hong KP, Chang SH, Kim KS, Kim KH, Park CK, Lee BD, et al. Assessment of quality of life in laryngectomees. Korean J Otolayrngol 1996;39: ) Wang SG. Quality of life (QOL) of the patients following treatment for laryngeal cancer. Korean J Otolaryngol 1996;39: ) The WHOQOL group. The World Health Organization Quality of Life assessment (WHOQOL): Developement and general psychometric properties. Soc Sci Med 1998;46: ) Drettner B, Ahlborn A. Quality of life and state of health for patients with cancer in the head and neck. Arch Otolaryngol Head Neck Surg 1983;96: ) Terrell JE, Fisher SG, Wolf GT. Long-term Quality of life after treatment of laryngeal cancer. Arch Otolaryngol Head Neck Surg 1998;124: ) Han HM, Yeum TH, Sin YO, Kim GH, Yoon DJ, Jeong GJ. A standardization study of Beck depression inventory in korea. J Psychiatr Assoc 1986;25: ) The WHOQOL group. Developement of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998;28: ) Tazaki1 M, Nakane Y, Endo T, Kakikawa F, Kano1 K, Kawano H. Results of a qualitative and field study using the WHOQOL instrument for cancer patients. Jpn J Clin Oncol;1998. p ) Skevington SM. Investigating relationship between pain and discomfort and quality of life, using the WHOQOL. Pain 1998; 76: ) Finizia C, Hammerlid E, Westin T, Lindstrom J. Quality of life and voice in patients with laryngeal carcinoma: A posttreatment comparison of laryngectomy (salvage surgery) versus radiotherapy. Laryngoscope 1998;108: ) Herranz J, Gavilan J. Psychosocial adjustment after laryngeal cancer surgery. Ann Otol Rhinol Laryngol 1999;108: ) Lazarus CL, Logemann JA, Pauloski BP, Colangelo LA, Kahrilas PJ, Mittal BB. Swallowing disorders in head and neck cancer patients treated with radiotherapy and adjuvant chemotherapy. Laryngoscope 1996;106: ) Takeo Sakai. Psychosomatic analysis of laryngectomized patients. J Otolaryngol Jpn 1994;97: ) Desanto LW, Olsen KD, Perry WC, Rohe DE, Keith RL. Quality of life after surgical treatment of cancer of larynx. Ann Otol Rhinol Laryngol 1995;104: ) Deleyiannis FWB, Weymuller EA, Coltrera MD, Futran N. Quality of life after laryngectomy: Are functional disabilities important? Head Neck 1999;7: ) Meyers AD, Aarons B, Suzuki B. Sexual behavior following laryngectomy. Ear Nose Throat J 1980;159: ) Phillips T, FRCPC, Stanton B, Provan A, Lew R, Boston Massachusetts. A study of the impact of leg ulcer on quality of life: Financial, social, and psychologic implications J Am Acaed Dermatol 1994;31: Korean J Otolaryngol 2001;44:973-81

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Table 1. Distribution by site and stage of laryngeal cancer Supraglottic Glottic Transglottic Total Stage Total 20

Table 1. Distribution by site and stage of laryngeal cancer Supraglottic Glottic Transglottic Total Stage Total 20 KISEP Head and Neck Korean J Otolaryngol 1999;42:1284-9 후두암수술환자에대한치료성적 송달원 김희준 정현수 김영한 안재현 이복수 박선호 Treatment Result in Laryngeal Cancer Patients Submitted to Surgical Treatment Dal Won Song, MD, Hee Jun