Prediction of 5 year survival from level of perceived distress in newly diagnosed head and neck squamous cell carcinoma patients

Objectives: To evaluate the predictive effect of level of perceived distress on survival in a cohort of newly diagnosed head and neck squamous cell carcinoma (HNSCC) patients. Materials and methods: One hundred and one (N = 101) consecutive HNSCC patients self-reported their levels of distress, measured with the general health questionnaire 30 (GHQ-30) at the time of diagnosis. All included patients were younger than 78 years of age, cognitive adequate functioning, and scheduled for curative treatment. At the time of diagnosis self-reported levels of neuroticism, problem and avoidance focused coping, smoking and alcohol consumption, and sociodemographic information were registered. Clinical characteristics and comorbidities were determined from the patient hospital records. Results: The 5-year overall survival of the cohort was 68.3%. Thirty-two deaths occurred during the 5-year observation period. The Likert analyzed GHQ sum score, as well as a dichotomized GHQ score were found to predict survival in univariate Cox proportional hazards regression analyses. The hazard ratios were 1.04 (p = .04) and 2.78 (p = .01), respectively. The predictive effect of the GHQ scores remained significant throughout sequential multivariate analyses with adjustments for all the above mentioned covariates. Even a post hoc analysis including all covariates demonstrated an evident survival prediction. Conclusion: Self-reported distress measured pretreatment in newly diagnosed HNSCC patients predict survival. Further studies are warranted to elucidate mechanisms and possible interventions. (c) 2013 Elsevier Ltd. All rights reserved.