Long-Term Health-Related Quality of Life in Oropharyngeal Squamous Cell Carcinoma: A Systematic Review

Objective: Although short-term health-related quality of life (HRQoL) outcomes in survivors of oropharyngeal squamous cell carcinoma (OPSCC) are well characterized, long-term HRQoL outcomes (≥5 years posttreatment) are not well established. This systematic review aims to assess long-term HRQoL in OPSCC survivors and identify potential predictors influencing these outcomes. Data Sources: A comprehensive search of the literature was performed using PubMed, Embase, Web of Science, and Ovid All EBM Reviews (Cochrane). Review Methods: Studies met inclusion criteria if they were in English, included OPSCC patients ≥5 years posttreatment, and reported OPSCC-specific HRQoL outcomes measured by validated questionnaires. Results: The literature search returned 2656 articles for initial review, of which 7 (771 participants, range 9-396) met inclusion criteria. Heterogeneous reporting and lack of raw data precluded meta-analysis. Across validated instruments, survivors demonstrated persistent dysphagia, xerostomia, and diet restriction; however, global HRQoL was generally preserved. Subgroup analyses indicated that single-modality treatment and p16 positivity were associated with better long-term QoL, while advanced stage, base of tongue primary site, chemotherapy use, PEG-tube dependence, smoking or alcohol use at diagnosis, older age, and lower educational attainment predicted poorer QoL outcomes. Conclusion: Long-term OPSCC survivors experience persistent functional impairments despite generally preserved global HRQoL. Standardized, longitudinal studies are needed to better characterize predictors of long-term HRQoL and inform targeted survivorship interventions.