1.Health-Related Quality of Life among Patients with Oral Potentially Malignant Disorder and Oral Cancer in Malaysia
Sivaraj Raman ; Asrul Akmal Shafie ; Mannil Thomas Abraham ; Shim Chen Kiong ; Thaddius Herman Maling ; Senthilmani Rajendran ; Sok Ching Cheong
Archives of Orofacial Sciences 2022;17(1):101-111
ABSTRACT
Presently there is a lack of health-related quality of life (HRQOL) measure and its corresponding utility
values for oral cancer and oral potentially malignant disorders (OPMD). This limits patient-centered
outcomes for cost-effectiveness evaluations. The study aimed to determine post-treatment HRQOL
of patients and ascertained differences between OPMD, early and late-stage oral cancer. A cross-sectional survey was conducted among patients in oral maxillofacial specialist clinics in two public
tertiary hospitals. Consented participants were required to complete the EQ-5D-5L questionnaire with
the EQ Visual Analogue System (VAS). Kruskal-Wallis test was used to explore differences in values
between stages. Multiple linear regression was used to explore factors that influenced the HRQOL. A total of 50 OPMD and 52 oral cancer patients were surveyed. The mean EQ-5D-5L health utility
values was 0.842 (n = 50, SD = 0.139), 0.822 (n = 10, SD = 0.150) and 0.626 (n = 42, SD = 0.310)
for OPMD, early- and late-stage cancer, respectively. The mean values of the EQ-5D-5L index and
EQ-VAS scale showed significant differences between groups and between early- and late-stage cancer
with good discriminative properties. Results of the multiple linear regression indicated that ethnicity,
income, residency, diagnosis, and treatment modality were able to significantly account for 25% of
EQ-5D-5L utility values, F(10,91) = 3.83, p < 0.001, R2 = 0.360. Indian ethnicity, rural location,
income less than RM4,360, late-stage cancer, and multi-modal therapies were all predictors of poorer
HRQOL. This study evidenced disease severity and treatment modality to greatly impact the HRQOL of
patients, in addition to socio-demographic factors such as ethnicity and income.
Quality of Life
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Mouth Neoplasms