Trajectory patterns and factors associated with shoulder-related quality of life in patients with head and neck cancer after neck dissection: A longitudinal study.

purposeTo explore the trajectories of shoulder-related quality of life (QoL) in patients with head and neck cancer undergoing neck dissection, identify factors associated with each trajectory, and determine whether shoulder function differs across different trajectories.

methodsPatients with head and neck cancer who underwent neck dissection were followed up at 3 days, 2 weeks, 1 month and 3 months after surgery. A sociodemographic information questionnaire, the Neck Dissection Impairment Index, and the Constant-Murley score were completed. A latent class growth analysis was used to explore the trajectories of shoulder-related QoL.

resultsThe average age of the 92 patients with head and neck cancer who underwent neck dissection was 37.68 years. The majority of participants had thyroid cancer (88.0%). Two distinct shoulder-related QoL trajectories were identified: 45 patients (48.9%) in the "Persistently High QoL" group (trajectory 1) and 47 patients (51.1%) in the "Low QoL with Gradual Improvement" group (trajectory 2). When trajectory 1 was used as the reference, the predictors for trajectory 2 included irregular exercise and receiving Level V regional dissection. The Constant-Murley scores were consistently higher in the "Persistently High QoL" group than in the "Low QoL with Gradual Improvement" group, with statistically significant differences observed at postoperative day 3 (t = 3.979, P < 0.001), week 2 (t = 4.420, P < 0.001), and month 1 (t = 3.436, P = 0.001).

conclusionWe identified two trajectories of shoulder-related QoL. Dynamic and individualized exercise rehabilitation interventions should be continuously provided to ensure that patients recover better shoulder function and improve their shoulder-related QoL.