Long-Term Health-Related Quality of Life in Oropharyngeal Squamous Cell Carcinoma: A Systematic Review.

Abstract

Although short-term health-related quality of life (HRQoL) outcomes in survivors of oropharyngeal squamous cell carcinoma (OPSCC) are well characterized, long-term HRQoL outcomes (≥5 years posttreatment) are not well established. This systematic review aims to assess long-term HRQoL in OPSCC survivors and identify potential predictors influencing these outcomes. A comprehensive search of the literature was performed using PubMed, Embase, Web of Science, and Ovid All EBM Reviews (Cochrane). Studies met inclusion criteria if they were in English, included OPSCC patients ≥5 years posttreatment, and reported OPSCC-specific HRQoL outcomes measured by validated questionnaires. The literature search returned 2656 articles for initial review, of which 7 (771 participants, range 9-396) met inclusion criteria. Heterogeneous reporting and lack of raw data precluded meta-analysis. Across validated instruments, survivors demonstrated persistent dysphagia, xerostomia, and diet restriction; however, global HRQoL was generally preserved. Subgroup analyses indicated that single-modality treatment and p16 positivity were associated with better long-term QoL, while advanced stage, base of tongue primary site, chemotherapy use, PEG-tube dependence, smoking or alcohol use at diagnosis, older age, and lower educational attainment predicted poorer QoL outcomes. Long-term OPSCC survivors experience persistent functional impairments despite generally preserved global HRQoL. Standardized, longitudinal studies are needed to better characterize predictors of long-term HRQoL and inform targeted survivorship interventions.