Prospective Cohort Study of Body Image Disturbance in Surgically-Managed Head and Neck Cancer Patients Evan Graboyes MD Department of Otolaryngology-Head & Neck Surgery Cancer Control Program, Hollings Cancer Center Medical University of South Carolina

HNC arises in cosmetically + functionally Background: Exposure HNC arises in cosmetically + functionally  highly visible, socially significant changes Significant psychosocial morbidity Depression Occurs in 50% of HN patients during Rx Suicide 2x increased adjusted odds vs any other cancer Lydiatt et al. JAMA Oto-HNS 2014 Osazuwa-Peters et al. Cancer 2018

Body Image Disturbance Background: Outcome Body Image Disturbance multi-D phenom of self-perceived change in appearance and/or function Common: up to 75% of HNC pts Significant psychosocial impairment Assessed using PROMs Rhoten et al. Oral Oncol 2013 Graboyes et al. OtoHNS 2018

Study Question/Hypothesis Prior studies w/ cross sectional design Uncertain risk factors for BID prevents targeting of prevention and treatment strategies Hypothesis: Baseline (pre-treatment) depression predicts development of post-treatment BID

Study Design and Population Design: Prospective cohort study Inclusion Criteria > 18 years of age SCC of OC, OP, HP, Lx or cutaneous malignancy of HN Surgery at MUSC+/- reconstruction +/- adjuvant therapy Exposure Status Baseline (Pre-treatment) Depression vs No-Depression

Methods: Exposure, Covariates, Outcome Depression Covariates Sociodemographics and severity of comorbidity Oncologic + treatment characteristics PROMIS: Satisfaction w/ roles, social isolation Shame and Stigma Scale Performance Status Scale-HN Primary Outcome Measure Body Image Scale

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