頭頚部がん喉頭摘出術後長期経過者におけるQOL関連因子の検討

Quality of Life-Related Factors in Patients with Long-Term Disease after Laryngectomy for Head and Neck Cancer

要旨　目的：頭頚部がん喉頭摘出者（喉摘者）の状況を機能，活動，参加，環境などから調査し，quality of life（QOL）関連因子を検討する．

方法：対象は，日本喉摘者団体所属の喉摘者とした．調査項目は，基本属性，QOL，サルコペニア，頚部・上肢機能，上肢関連activities of daily living（ADL）などとした．統計解析は，相関分析後に多重ロジスティック回帰分析を行い，QOL関連因子を検討した．

結果：有効回答者数は272人であり，年齢の中央値は74.0歳，喉頭摘出術後経過期間の中央値は8.7年，喉頭摘出術後就労継続者は94人であった．QOL関連因子には，上肢関連ADL，サルコペニア，頚部・上肢機能が抽出された．

結論：喉摘者のQOL関連因子は，頚部・上肢機能，上肢関連ADL，サルコペニアであり，QOL向上にはこれらに対するリハビリテーション治療が重要と考えられた．

Abstract　Objective：To research studies on patients with head and neck cancer who underwent laryngectomy (patients with laryngectomy) in terms of function, activity, participation, and environment, and examine quality of life (QOL) -related factors.

Methods：The participants were patients who underwent laryngectomy and belonged to the Japanese Laryngectomy Clubs. We investigated basic attributes, QOL, sarcopenia, neck and upper limb function, and upper limb-related activities of daily living (ULADL). Statistical analysis was performed using multiple logistic regression analysis after correlation analysis to investigate QOL-related factors.

Results：The number of valid responders was 272 patients, median age was 74.0 years, median postoperative follow-up was 8.7 years, and 94 were still employed after surgery. Multiple logistic regression analysis results revealed that factors related to QOL included ULADL, sarcopenia, and neck and upper limb function.

Conclusions：The QOL-related factors of laryngectomy were neck and upper limb function, ULADL, and sarcopenia. Rehabilitation for these factors is considered important in improving QOL.