Assessment of Patient Expectations and Preferences Following OPHL: Results from an Evaluation Study

Open partial horizontal laryngectomy (OPHL) is a key conservative option for laryngeal cancer, with established oncological outcomes but limited data on functional results and patient perspectives. Voice preservation is mainly associated with type I OPHL, whereas types II-III often result in significant but broadly comparable impairments, making vocal decline the main limitation of OPHL. Patient-reported outcomes (PROs) help clarify the balance between treatment efficacy and side effects. This single-institution study analyzed 70 consecutive OPHL patients (12 women, 17.1%; 58 men, 82.9%), mean age 65.9 years (SD 8.96), with a median follow-up of 52.5 months (range 2-218). PROs were assessed using the Priority Scale, the V-RQOL, the MDADI, the Decisional Conflict Scale, the Decisional Regret Scale, and the Brief Pain Inventory. The Priority Scale showed that curing cancer (98.6%) and prolonging life (82.9%) were top concerns, while only 34.3% prioritized natural voice preservation. V-RQOL averaged 77.4/100, indicating limited impact of voice on quality of life; MDADI was 78.5/100, reflecting minimal swallowing difficulties. Decisional Conflict averaged 34.3/100, with 30% reporting no difficulty; Decisional Regret was low (13.0/100), with only 1.4% expressing moderate regret. Most patients (78.6%) reported no pain. Overall, OPHL provided satisfactory functional and decisional outcomes, with high patient satisfaction despite the complexity of treatment.