Quality of life following treatment for T1a glottic cancer with surgery or radiotherapy: outcomes from the Head and Neck 5000 cohort

James O'Hara, Alex Whitmarsh, Miranda Pring, Steve Thomas, Andy Ness

Research output: Contribution to journalArticle (Academic Journal)peer-review


INTRODUCTION: Recent guidelines have stated transoral laser microsurgery be recommended for the management of T1a glottic carcinoma over radiotherapy. If radiotherapy offered superior quality of life (QoL) outcomes, this guidance would need revisiting. There is a paucity of good quality evidence on QoL outcomes.

DESIGN: This prospective cohort study aims to assess generic and disease specific patient reported QoL in patients treated with either surgery or RT for T1a glottic carcinoma.

PARTICIPANTS: Participants were recruited as part of the multicentre, prospective Head and Neck 5000 cohort between 2011 and 2014.

MAIN OUTCOME MEASURES: Baseline demographic data were collected. All participants completed the EORTC QLQ C30 and EORTC QLQ H&N35 questionnaires at baseline, 4 months, 12 months, and after 36 months.

RESULTS: 123 participants received radiotherapy only (n=68) or surgery only (n=55). Overall QoL scores were similar between both groups. The median (IQR) EORTC QLQ C30 summary scores at 12 months were 89.3 (79.1, 95.7) and 92.6 (74.4, 97.9) for the radiotherapy and surgery groups respectively. The equivalent summary scores for the EORTC QLQ H&N35 were 91.9 (83.8, 94.9) and 90.4 (85.5, 94.9). There was a modest difference in some QoL subscales between the groups but no differences existed beyond 4 months.

CONCLUSIONS: Patient reported QoL is similar following either radiotherapy or surgery for T1a glottic carcinoma. This data supports current guidance recommended TLM for this disease.

Original languageEnglish
Pages (from-to)67-74
Number of pages8
JournalClinical Otolaryngology
Issue number1
Early online date15 Aug 2021
Publication statusPublished - Jan 2022

Bibliographical note

Funding Information:
We would like to thank the people with head and neck cancer who took part in this study. We would also like to thank the research, laboratory and clinical staff who supported this study. We would like to thank Jake Begbie for his assistance in initially analysing the data. This publication presents data from the Head and Neck 5000 study. The study was a component of independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP‐PG‐0707‐10034). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Core funding was also provided through awards from Above and Beyond, University Hospitals Bristol Research Capability Funding and the NIHR Senior Investigator award to Professor Andy Ness. Human papillomavirus (HPV) serology was supported by a Cancer Research UK Programme Grant, the Integrative Cancer Epidemiology Programme (grant number: C18281/A19169).

Publisher Copyright:
© 2021 John Wiley & Sons Ltd.


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