Communicative Participation and Quality of Life in Pretreatment Oral and Oropharyngeal Head and Neck Cancer

Objective To determine how communicative participation is affected in patients with oral and oropharyngeal head and neck cancers (HNCs) pretreatment and whether communication function predicts HNC-specific quality of life (QOL) before treatment, beyond known demographic, medical, psychosocial, and swallowing predictors. Study Design Cross-sectional study. Setting Tertiary care academic medical center. Methods Eighty-seven patients with primary oral (40.2%) or oropharyngeal (59.8%) HNC were recruited prior to treatment. T stage, tumor site, and p16 status were extracted from medical records. Demographic and patient-reported measures were obtained. Communicative participation was measured using the Communicative Participation Item Bank (CPIB) General short form. A hierarchical regression analysis included demographic, medical, psychosocial, and functional measures of swallowing and communication as predictors; the University of Washington Quality of Life (UW-QOL v4) composite score was the predicted variable. Results Median (SD) baseline CPIB scores were 71.0 (11.83); patients with oral cancers reported worse scores. A final sequential hierarchical regression model that included all variables explained 71% of variance in QOL scores. Tumor site, T stage, and p16 status accounted for 28% of variance (P< .001). Perceived depression predicted an additional 28% of the variance (P< .001). Swallowing and communicative participation together predicted an additional 12% of variance (P= .005). Tumor site, perceived depression, swallowing, and communication measures were unique predictors in the final model. Finally, communicative participation uniquely predicted QOL, above and beyond other predictors. Conclusion Pretreatment communication predicted QOL and was negatively affected in some oral and oropharyngeal patients with HNC.