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

## TL;DR

This study explores patient expectations and satisfaction after a specific laryngeal cancer surgery, finding that most patients prioritize cancer control over voice preservation and report high satisfaction post-surgery.

## Contribution

The study provides new insights into patient-reported outcomes and preferences following open partial horizontal laryngectomy for laryngeal cancer.

## Key findings

- Most patients prioritized curing cancer and prolonging life over preserving a natural voice.
- Post-surgery, patients reported good voice and swallowing quality of life with minimal pain and regret.
- Only a small number of patients experienced substantial uncertainty about their treatment choice.

## Abstract

Laryngeal cancer can affect breathing, speech and swallowing, and treatment often requires balancing disease control with the preservation of daily functions such as voice. Open partial horizontal laryngectomy (OPHL) is a surgical procedure designed to remove the tumor while preserving part of the larynx, but its impact on patients’ quality of life is not fully understood. This study aimed to explore what matters most to patients before surgery and how satisfied they feel afterward. We analyzed the experiences of 70 people treated with OPHL and asked them to report their priorities, their voice and swallowing abilities, their level of pain, and whether they had doubts or regrets about their decision. Most patients said that curing the cancer and living longer were their main goals, while keeping a natural voice was less important. After surgery, most reported good quality of life regarding both voice and swallowing, very low levels of regret, and little or no pain. Only a small number of patients experienced substantial uncertainty regarding their treatment choice. Overall, these results suggest that OPHL offers an acceptable balance between cancer control and everyday functioning, and may provide valuable information to patients, families, and caregivers when discussing treatment options.

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.