0000000000025271
AUTHOR
Helge Danker
Quality of life before and after total laryngectomy: Results of a multicenter prospective cohort study
Background The purpose of this study was to determine what quality of life (QOL) areas improve and deteriorate during the first year after total laryngectomy and to identify predictors of these changes. Methods One hundred seventy-four patients completed the European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaires before laryngectomy, n = 133 before discharge from hospital, n = 110 at the end of rehabilitation, and n = 86 1 year after laryngectomy. Multivariate regression analysis was performed to estimate the effect of potential predictors on QOL. Results Areas that did not recover to baseline level were physical functioning, role functioning, social functionin…
Soziale Integration und deren Bedeutung für die Lebensqualität nach Laryngektomie
Soziale Netzwerke und gesellschaftliche Teilhabe wirken sich im Allgemeinen positiv auf das psychische Befinden aus. Inwiefern Patienten nach einer Kehlkopfentfernung wieder in die Gesellschaft eingebunden werden, ist jedoch wenig untersucht. Ziel der Studie war es, zu prufen, inwieweit Patienten nach einer Laryngektomie sozial integriert sind und ob die soziale Integration mit bestimmten Bereichen der Lebensqualitat zusammenhangt. In einer multizentrischen Studie wurden 161 Patienten ein Jahr nach Laryngektomie befragt. Die soziale Integration wurde anhand eines Index erhoben. Dieser setzt sich aus Fragen zur sozialen Unterstutzung und dem Fragenkomplex zur Einbindung in die Gesellschaft, …
Effects of stepped psychooncological care on referral to psychosocial services and emotional well-being in cancer patients: A cluster-randomized phase III trial
Objective Emotional distress in cancer patients often goes unnoticed in daily routine; therefore, distress screening is now recommended in many national guidelines. However, screening alone does not necessarily translate into better well-being. We examined whether stepped psychooncological care improves referral to consultation-liaison (CL) services and improves well-being. Methods In a cluster-randomized trial, wards were randomly allocated to stepped versus standard care. Stepped care comprised screening for distress, consultation between doctor and patient about the patient's need for CL services, and provision of CL service. Primary outcomes were referral to psychosocial services and em…
Factors associated with non-participation and dropout among cancer patients in a cluster-randomised controlled trial
We investigated the impact of demographic and disease related factors on non-participation and dropout in a cluster-randomised behavioural trial in cancer patients with measurements taken between hospitalisation and 6 months thereafter. The percentages of non-participation and dropout were documented at each time point. Factors considered to be potentially related with non-participation and dropout were as follows: age, sex, marital status, education, income, employment status, tumour site and stage of disease. Of 1,338 eligible patients, 24% declined participation at baseline. Non-participation was higher in older patients (Odds Ratio [OR] 2.1, CI: 0.6-0.9) and those with advanced disease …
Tobacco and alcohol consumption after total laryngectomy and survival: A German multicenter prospective cohort study
Background We examined the relation of tobacco and alcohol consumption after total laryngectomy with overall survival (OS). Methods Tobacco and alcohol consumption was assessed at 5 time points after total laryngectomy. Patients were followed up for survival until December 31, 2014. A multivariate Cox regression was fitted to test for differences in OS. Results Three hundred fifty-nine patients were included in this study. Compared to former smokers, never smokers had hazard ratios (HRs) of 0.88 (95% confidence intervals [CIs] = 0.50–1.59), and continuous smokers 1.31 (95% CI = 0.87–1.96). Constantly high alcohol consumption after total laryngectomy had an HR of 2.19 (95% CI = 1.30–3.67). D…
Impact of socio-economic position on cancer stage at presentation: Findings from a large hospital-based study in Germany
We explored the relationship between socio-economic characteristics and cancer stage at presentation. Patients admitted to a university hospital for diagnosis and treatment of cancer provided data on their education, vocational training, income, employment, job, health insurance and postcode. Tumor stage was classified according to the Union International Contre le Cancer (UICC). To analyze disparities in the likelihood of late-stage (UICC III/IV vs. I/II) diagnoses, logistic regression models adjusting for age and gender were used. Out of 1,012 patients, 572 (59%) had late-stage cancer. Separately tested, increased odds of advanced disease were associated with post-compulsory education com…