Investigating quality of life and decision regret in patients undergoing laryngectomy procedure.

Abstract

e23267 Background: Total laryngectomy is a surgical procedure for head and neck cancers that involves the removal of the larynx and tongue. This operation negatively impacts key functions such as speech, swallowing, and breathing. The primary purpose of this study is to describe the quality of life among patients who have undergone total laryngectomy with adjuvant radiation or salvage laryngectomy. In addition, the study examines the level of decision regret in these groups. These findings will inform best practices, including improving patient awareness of potential outcomes and challenges following surgery. Methods: The survey was distributed to two groups of patients who had undergone a laryngectomy procedure. The first group included 25 patients who received a primary laryngectomy with adjuvant radiotherapy/treatment, while the 27 patients in the second group underwent salvage laryngectomy. Their quality of life was assessed using the University of Washington Quality of Life Questionnaire (UW-QOL). The Decision Regret Scale was utilized to evaluate the patients’ perspectives on their treatment decisions. Results: Previous studies have revealed that an MDADI score of 60 and above represents an adequate quality of life. According to our analysis, we found that Group 1 patients have a mean MDADI score of 70.28, while Group 2 patients have a lower 63.90 score. The 95% confidence interval (CI) (55.8 – 72.0) of Group 2 patients lies below the benchmark of 60, unlike the CI of the Group 1 patients (64.6 – 75.9). For the Decision Regret, any score over 26 is clinically significant regret, and a score of 40 and above shows total regret of their decision. Group 1 patients reported a decision regret score of 31.4, whereas Group 2 patients had a higher score of 35.37, indicating greater regret. Overall, this shows that while both patient groups report an adequate quality of life with moderate decision regret, Group 1 demonstrates better outcomes compared to Group 2. Conclusions: Our results demonstrate that patients who undergo laryngectomy with adjuvant therapy report a higher quality of life than those who undergo salvage laryngectomy, although both groups meet criteria for an adequate quality of life. Both groups demonstrate clinically significant decision regret, though neither group demonstrated total regret. These findings highlight the importance of fully informing patients of the impact of surgery on quality of life to assist them in their decision-making. Future studies can recruit larger cohorts and investigate the effectiveness of other laryngectomy treatments/procedures.