Stimmfunktion und Lebensqualität: Patienten mit Larynxkarzinom nach minimal-invasiver Laserchirurgie und „Funktionaler Stimmrehabilitation”

Background: Quality of life is a relevant criterion for therapeutical outcome in laryngeal carcinoma patients. The aim of this study was to assess the self-related complaints in quality of life and functional outcome of voice among persons who had undergone laryngeal cancer surgery. Methods: The examination took place 67 months (SD 34.8) after the last surgery, on average and finishing of 60 therapy sessions (median). First a measurement with the Goettinger Hoarseness Diagram (GHD) was carried out. Next the subjects answered self-reported standardized questionnaires for life quality in oncological patients on the same day: EORTC-QLQ-C30 and 3 scales of the German Fragebogen zur Lebenszufriedenheit (health-related fulfillment, fulfillment with work/occupation, fulfillment with social environment). For disease-related symptoms of different head and neck domains the EORTC-H&N35 was administered.Subjects: Forty-four patients (37 males, 7 females) who were treated primarily with minimal invasive laser surgery followed by functional voice rehabilitation (Goettinger Konzept). Mean age: 60.1 (SD 9.7) years.Results: The acoustic voice quality according to the GHD showed a significant correlation with self-reported "Somatic Functioning" (- 0.32, p = 0.04) and "Social Functioning" (- 0.38, p = 0.01) in the EORTC-QLQ-C30 as well as with the symptom scales "Speech" (0.45, p < 0.0024) resp. "Social Contact" (0.45, p = 0.0021) in the EORTC-H&N35. Also hoarseness and health-related fulfillment (- 0.36, p = 0.02) as well as fulfillment with work/occupation (- 0.33, p = 0.03) correlated significantly. On the other hand, there was no significant association between the GHD and the assessment of global quality of life. Conclusion: Postoperative phonatory reductions in patients with laser surgically treated laryngeal carcinoma have only a slight influence on overall quality of life. The same is true for the GHD. Assessment of self-reported quality of life in recommendation of oncologic treatment may not be able to replace the objective findings, but may be useful to detect other problems, e.g. psychosocial.