Pilot Study of Quality-of-Life Differences Between Surgical and Non-Surgical Organ Preservation Strategies in Head and Neck Cancer Patients

Introduction Head and neck cancer (HNC) treatments can significantly affect long-term quality of life, with different treatment modalities impacting other aspects of patient well-being. Our study aimed to evaluate quality of life (QoL), functional outcomes, and symptom impact in head and neck cancer (HNC) patients and to compare outcomes between patients who underwent definitive surgical treatment and those treated with non-surgical organ preservation therapy. Materials and methods A pilot cohort study was performed between September 2024 and September 2025 in Hippocrateion General Hospital, Athens, Greece, including 25 HNC patients diagnosed and treated with curative intent. Participants completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Quality of Life Questionnaire-Head and Neck 35 (QLQ-H&N35) (Greek versions) at least three months after their treatment. Statistical analysis was performed using SPSS, and p-values <0.05 were considered significant. Results From the 25 participants, 13 had surgical treatment, and 12 underwent non-surgical organ preservation therapy (radiotherapy ± chemotherapy). The mean global QoL score was 59.3, higher in the surgical group than in the chemoradiotherapy group (65.36 vs. 52.73, p=0.15). Functional outcomes were good overall, with a mean functional score of 77.84 and slightly better results in the surgical group (81.05 vs. 74.35). Fatigue was the most common symptom (mean score 41.72), particularly in the chemoradiotherapy group (48.1 vs. 35.83, p 0.18). In the QLQ-H&N35 questionnaire, painkiller use, sensory loss (taste and smell), and sexual problems were the main problems in surgical patients. In contrast, xerostomia and weight loss were the main concerns among the non-surgical organ preservation group. Conclusions Patients from both treatment groups had satisfactory QoL; however, symptom profiles differed between the groups. Surgical patients used painkillers more commonly and had more sensory disturbances, impacting their quality of life. In contrast, those treated with non-surgical organ preservation therapy had more common fatigue, problems with xerostomia, and weight loss. These modality-specific challenges should be considered in personalised survivorship to optimise post-treatment recovery and good quality of life in HNC patients.