头颈癌患者治疗结束后重返工作岗位长达5年。

IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY
Femke Jansen, Simone E J Eerenstein, Sara Arman, Birgit I Lissenberg-Witte, Jose A Hardillo, Robert P Takes, Ruud H Brakenhoff, Remco de Bree, Femke Lamers, Johannes A Langendijk, C René Leemans, Irma M Verdonck-de Leeuw
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引用次数: 0

摘要

重要性:癌症及其治疗的不良影响可能阻碍头颈癌(HNC)患者重返工作岗位(RTW)。目的:调查HNC患者治疗结束至治疗后5年的RTW,以及RTW与社会人口统计学、临床、工作相关、个人、生活方式、身体和心理因素以及癌症相关症状的关系。设计、环境和参与者:这项HNC患者的前瞻性、纵向、多中心队列研究使用了来自荷兰生活质量和生物医学队列的数据。这项研究的重点是年龄小于65岁的患者(对年龄小于60岁的患者进行亚分析),从癌症诊断时间(2014年3月至2018年6月)到治疗结束后5年(2019年1月至2023年7月)。数据分析时间为2023年4月至2024年8月。暴露:标准临床护理。主要结果和测量方法:在治疗后3个月和6个月,以及1、2、3、4和5年,使用调整版的生产力成本问卷测量工作状态。采用Cox回归分析调查与RTW时间相关的因素(基线、3个月和6个月)。结果:年龄小于65岁的HNC患者共184例(平均[SD]年龄55.4[7.0]岁;纳入146名男性(79%),其中77名(42%)患有口咽癌。RTW从3个月时的26%(160只中有42只)增加到1年时的65%(137只中有89只),之后在5年时下降到52%(98只中有51只)。在治疗5年后,98名参与者中又有28人(29%)退休。小手术(与大手术相比)与治疗结束后更快的RTW相关(风险比[HR], 2.73;95% ci, 1.17-6.37)。老年(HR, 0.97;95% CI, 0.94-0.999), 3个月时疲劳加重(HR, 0.99;95% CI, 0.98-0.995)与3个月后较慢的RTW相关。年龄越大,6个月后RTW越慢(HR, 0.96;95% ci, 0.93-0.998)。在127例60岁以下HNC患者中,治疗5年后RTW为72%(47例)。肿瘤晚期(HR, 0.59;95% CI, 0.39-0.90)和更多的疲劳(HR, 0.99;95% CI, 0.98-0.999)与该组较慢的RTW相关。结论和相关性:该队列研究发现,荷兰大多数HNC患者在1年内重返工作岗位,某些社会人口统计学和临床因素以及癌症相关症状与RTW时间相关。这些结果可能为HNC患者提供信息,并为改善RTW的潜在目标(如疲劳)提供见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Return to Work Up to 5 Years After the End of Treatment Among Patients With Head and Neck Cancer.

Importance: Adverse effects of cancer and its treatment may hamper return to work (RTW) among patients with head and neck cancer (HNC).

Objectives: To investigate RTW among patients with HNC from end of treatment to 5 years after treatment and associations of RTW with sociodemographic, clinical, work-related, personal, lifestyle, physical, and psychological factors and cancer-related symptoms.

Design, setting and participants: This prospective, longitudinal, multicenter cohort study of patients with HNC used data from the Netherlands Quality of Life and Biomedical cohort. This study focused on patients younger than 65 years (with a subanalysis of patients younger than 60 years) from time of cancer diagnosis (March 2014 to June 2018) to 5 years after end of treatment (January 2019 to July 2023). Data analysis occurred from April 2023 to August 2024.

Exposure: Standard clinical care.

Main outcomes and measures: Work status was measured at 3 and 6 months, and 1, 2, 3, 4, and 5 years after treatment using an adjusted version of the Productivity Cost Questionnaire. Cox regression analyses were performed to investigate factors (baseline, 3 months, and 6 months) associated with time to RTW.

Results: A total of 184 patients with HNC younger than 65 years (mean [SD] age, 55.4 [7.0] years; 146 men [79%]) were included and 77 (42%) had oropharyngeal cancer. RTW increased from 26% (42 of 160 individuals) at 3 months to 65% (89 of 137 individuals) at 1 year, after which it reduced to 52% (51 of 98 individuals) at 5 years. At 5 years after treatment, an additional 28 of 98 participants (29%) were retired. Minor surgery (vs major surgery) was associated with faster RTW from end of treatment onwards (hazard ratio [HR], 2.73; 95% CI, 1.17-6.37). Older age (HR, 0.97; 95% CI, 0.94-0.999) and more fatigue at 3 months (HR, 0.99; 95% CI, 0.98-0.995) were associated with slower RTW from 3 months onwards. Older age was also associated with slower RTW from 6 months onwards (HR, 0.96; 95% CI, 0.93-0.998). Among the 127 patients with HNC younger than 60 years, RTW was 72% (47 individuals) at 5 years after treatment. Advanced tumor stage (HR, 0.59; 95% CI, 0.39-0.90) and more fatigue (HR, 0.99; 95% CI, 0.98-0.999) were associated with slower RTW in this group.

Conclusion and relevance: This cohort study found that the majority of patients with HNC in the Netherlands returned to work within 1 year and that certain sociodemographic and clinical factors and cancer-related symptoms were associated with time to RTW. These results may inform patients with HNC and provide insight into potential targets, such as fatigue, to improve RTW.

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来源期刊
CiteScore
9.10
自引率
5.10%
发文量
230
期刊介绍: JAMA Otolaryngology–Head & Neck Surgery is a globally recognized and peer-reviewed medical journal dedicated to providing up-to-date information on diseases affecting the head and neck. It originated in 1925 as Archives of Otolaryngology and currently serves as the official publication for the American Head and Neck Society. As part of the prestigious JAMA Network, a collection of reputable general medical and specialty publications, it ensures the highest standards of research and expertise. Physicians and scientists worldwide rely on JAMA Otolaryngology–Head & Neck Surgery for invaluable insights in this specialized field.
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