Functional Performance One Year After Treatment in Older Individuals With Head and Neck Cancer

Introduction: Functional independence is valued over survival as health outcome priority by older adults with head and neck cancer (HNC). However, little is known on the effect of HNC treatment on long-term functional performance of older adults. The aim of this study is to evaluate functional performance of older patients and quality of life one year after receiving curative treatment for HNC.

Methods: Patients with HNC and aged ≥70 years, and aged ≥50 and <70 years with a G8 score ≤14 were prospectively included. All patients received a comprehensive geriatric assessment at baseline. We present one year follow-up data of patients, who underwent curative treatment for HNC. Changes in functional status were evaluated by comparing living situation, KATZ Index Activities of Daily Living (ADL) and Lawton Index Instrumental Activities of Daily Living (IADL) at baseline to 1 year follow-up. Logistic regression was used to evaluate associations of baseline characteristics with the composite outcome of functional decline or death.

Results: In total, 393 were included, of which 97 (24.6%) patients died within the first year.
Follow-up data was collected from 193 (49.1%) patients, nonetheless, 103 (26.2%) did not returned the follow-up questionnaire. Of the 193 patients, 98 (51%) reported a functional decline at one-year follow-up, including all ADL and IADL categories, except for housekeeping which showed a significant improvement (p= 0.024). Baseline comorbidity level and tumor stage were associated with 1-year functional decline or death, whereas radiotherapy versus surgical treatment was not.

Conclusions: Functional decline was highly prevalent in older HNC patients who survived the first year after curative treatment.