Journal of voice : official journal of the Voice Foundation · 2026
Quality of Life Trajectories After Partial Laryngectomy Versus Total Laryngectomy Stratified by Voice Rehabilitation Success.
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Park Sang Hoo, Kim Younghac, Kim Eun-Hye, Cheong Taek Yoon, Chung Man Ki, Jeong Han-Sin, Son Young-Ik, Choi Nayeon
Аннотация
BACKGROUND: Although partial laryngectomy (PL) is often preferred for functional preservation, long-term quality-of-life (QoL) outcomes after total laryngectomy (TL) may vary according to voice rehabilitation success. We compared five-year longitudinal QoL trajectories among PL, TL with successful voice rehabilitation (TL-S), and TL with failed rehabilitation (TL-F).
METHODS: Ninety-two patients were categorized into PL (n = 52), TL-S (n = 21), and TL-F (n = 19). QoL was assessed from baseline to 5 years postoperatively using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Head and Neck Cancer-Specific Module (EORTC QLQ-H&N35) at multiple intervals (pre-op, 1 month, 3 months, 1 year, 2 years, and 5 years). Longitudinal patterns were evaluated across multiple functional and symptom domains. Longitudinal within-group changes were analyzed using generalized estimating equations, and supplementary between-group comparisons at each time point were performed using the Kruskal-Wallis test.
RESULTS: By 5 years, the TL-S group showed a Summary Score comparable to that of the PL group, whereas global health status/QoL remained higher in the PL group. The TL-S group also showed more favorable Speech scores at 5 years, with swallowing outcomes approaching those of the PL group at later time points. In contrast, the TL-F group showed persistently higher swallowing-related burden, with broader symptom burden, including Social Contact problems and Financial Difficulties, remaining more pronounced over time.
CONCLUSIONS: Voice rehabilitation status may be associated with long-term QoL patterns after laryngeal cancer surgery. Successful rehabilitation after TL may be associated with more favorable long-term QoL patterns, with outcomes in selected domains approaching those of the PL group, whereas unsuccessful rehabilitation may be associated with persistently poorer outcomes.
METHODS: Ninety-two patients were categorized into PL (n = 52), TL-S (n = 21), and TL-F (n = 19). QoL was assessed from baseline to 5 years postoperatively using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Head and Neck Cancer-Specific Module (EORTC QLQ-H&N35) at multiple intervals (pre-op, 1 month, 3 months, 1 year, 2 years, and 5 years). Longitudinal patterns were evaluated across multiple functional and symptom domains. Longitudinal within-group changes were analyzed using generalized estimating equations, and supplementary between-group comparisons at each time point were performed using the Kruskal-Wallis test.
RESULTS: By 5 years, the TL-S group showed a Summary Score comparable to that of the PL group, whereas global health status/QoL remained higher in the PL group. The TL-S group also showed more favorable Speech scores at 5 years, with swallowing outcomes approaching those of the PL group at later time points. In contrast, the TL-F group showed persistently higher swallowing-related burden, with broader symptom burden, including Social Contact problems and Financial Difficulties, remaining more pronounced over time.
CONCLUSIONS: Voice rehabilitation status may be associated with long-term QoL patterns after laryngeal cancer surgery. Successful rehabilitation after TL may be associated with more favorable long-term QoL patterns, with outcomes in selected domains approaching those of the PL group, whereas unsuccessful rehabilitation may be associated with persistently poorer outcomes.