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Objective: Early‐stage glottic cancer (ESGC) is a malignancy of the head and neck. Besides disease control, preservation and improvement of voice quality are essential. To enable expectation management and well‐informed decision‐making, patients should be sufficiently counseled with individualized information on expected voice quality. This study aims to develop an individualized dynamic prediction model for patient‐reported voice quality. This model should be able to provide individualized predictions at every time point from intake to the end of follow‐up. Study Design: Longitudinal cohort study. Setting: Tertiary cancer center. Methods: Patients treated for ESGC were included in this study (N = 294). The Voice Handicap Index was obtained prospectively. The framework of mixed and joint models was used. The prognostic factors used are treatment, age, gender, comorbidity, performance score, smoking, T‐stage, and involvement of the anterior commissure. The overall performance of these models was assessed during an internal cross‐validation procedure and presentation of absolute errors using box plots. Results: The mean age in this cohort was 67 years and 81.3% are male. Patients were treated with transoral CO2 laser microsurgery (57.8%), single vocal cord irradiation up to (24.5), or local radiotherapy (17.5%). The mean follow‐up was 43.4 months (SD 21.5). Including more measurements during prediction improves predictive performance. Including more clinical and demographic variables did not provide better predictions. Little differences in predictive performance between models were found. Conclusion: We developed a dynamic individualized prediction model for patient‐reported voice quality. This model has the potential to empower patients and professionals in making well‐informed decisions and enables tailor‐made counseling. [ABSTRACT FROM AUTHOR]

Objective: Patients with palliative head and neck cancer experience many symptoms in a short period of time. Longitudinal data on patient‐reported outcomes in this phase are lacking. The aim of this study is to use structurally obtained patient‐reported outcome data combined with clinical patient data and obtain insight in patient‐reported outcomes, survival, circumstances of death, and interventions and treatment during the palliative phase in order to improve the quality of end‐of‐life care and patient‐centered counseling. Study Design: Longitudinal observational cohort study. Setting: Tertiary cancer center. Method: Quality of life was prospectively collected using the European Organization for Research and Treatment of Cancer QLQ‐C15‐PAL. Tumor‐ and patient‐specific data were retrospectively collected. Descriptive statistics, linear mixed models, and regression analyses were performed. Results: A significant deterioration was found in global health status, physical functioning, fatigue, dyspnea, appetite loss, and constipation over time. However, emotional functioning improved. Median survival was 5.1 months, and only a low percentage of in‐hospital death was observed (7.8%). Higher global health status at intake was associated with prolonged survival. Conclusion: Structural measurement of patient‐reported outcome together with clinical outcomes provides unique insight, which enables improvement of patient‐centered counseling and care. [ABSTRACT FROM AUTHOR]

Objective: Patient‐reported voice quality is an important outcome during counseling in early‐stage glottic cancer. However, there is a paucity of adequate longitudinal studies concerning voice outcomes. This study aimed to investigate longitudinal trajectories for patient‐reported voice quality and associated risk factors for treatment modalities such as transoral CO2 laser microsurgery, single vocal cord irradiation, and local radiotherapy. Study Design: A longitudinal observational cohort study. Setting: Tertiary cancer center. Methods: Patients treated for Tcis‐T1b, N0M0 glottic cancer were included in this study (N = 294). The Voice Handicap Index was obtained at baseline and during follow‐up (N = 1944). Mixed‐effects models were used for investigating the different trajectories for patient‐reported voice quality. Results: The mean follow‐up duration was 43.4 (SD 21.5) months. Patients received transoral CO2 laser microsurgery (57.8%), single vocal cord irradiation (24.5%), or local radiotherapy (17.5%). A steeper improvement during the first year after treatment for single vocal cord irradiation (−15.7) and local radiotherapy (−12.4) was seen, compared with a more stable trajectory for laser surgery (−6.1). All treatment modalities showed equivalent outcomes during long‐term follow‐up. Associated risk factors for different longitudinal trajectories were age, tumor stage, and comorbidity. Conclusion: Longitudinal patient‐reported voice quality after treatment for early‐stage glottic cancer is heterogeneous and nonlinear. Most improvement is seen during the first year of follow‐up and differs between treatment modalities. No clinically significant differences in long‐term trajectories were found. Insight into longitudinal trajectories can enhance individual patient counseling and provide the foundation for an individualized dynamic prediction model. [ABSTRACT FROM AUTHOR]