Quality of life considerations for patients with anterior and central skull base malignancies
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CLINICAL STUDY
Quality of life considerations for patients with anterior and central skull base malignancies Christopher W. Noel1,2 · John R. de Almeida1,2 Received: 13 November 2019 / Accepted: 9 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction The extirpation of skull base malignancies may be associated with significant morbidity and can profoundly impact health related quality of life (HRQOL). In this review, we sought to provide an overview of HRQOL and the factors that influence it for patients with skull base malignancies. Materials and Methods Narrative review. Results HRQOL tends to improve in the months to years following treatment and is profoundly impacted by both tumor location and treatment approach. Wherever possible, HRQOL should always be elicited from the patient directly. Several HRQOL instruments have been used in this population including generic, site-specific and disease specific measures. Conclusion Given that HRQOL is a multidimensional concept with several important facets, validated disease-specific instruments are generally preferred. Keywords Skull base surgery · Quality of life · Patient reported outcome measures · Head and neck neoplasms · Anterior skull base neoplasm · Cranial base · Cranial neoplasm
Introduction Skull base malignancies represent a rare and heterogenous group of diseases that profoundly impact the well-being of patients and their families. Physical morbidity is of significant concern, and stems in large part from the proximity of these malignancies to vital structures including the brainstem, pituitary gland, frontal lobes, visual and nasal apparatus [1–4]. While tumor extirpation can improve morbidity, quality of life concerns can often persist for several years after treatment [5, 6]. Traditionally, the majority of research outcomes for skullbased tumors has focused on survival and complications. In spite of advances in multimodal treatment and surgical * John R. de Almeida [email protected] 1
Department of Otolaryngology–Head and Neck Surgery, Princess Margaret Cancer Centre– University Health Network, Faculty of Medicine, University of Toronto, 610 University Avenue, 3‑955, Toronto, ON M5G 2M9, Canada
Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
2
techniques, survival rates have plateaued and as a result, efforts have been directed towards incorporating quality of life as a key outcome parameter, balancing oncologic control with functional disability [7–9]. This review has been divided into two sections. In the first section, we will explore the topic of quality of life, including definitions and efforts to measure quality of life for patients with anterior and central skull base malignancies. The second section will provide an overview of key quality of life concerns and factors that influence it.
Quality of life—definitions and assessment Health Related quality of life Quality of life is a complex conc
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