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Head and Neck Surgery

(136) Depressive Symptoms and Tumor Response Among Head and Neck Cancer

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • Baylee R. Polzin, Other

    Medical Student
    University of Louisville School of Medicine
    Louisville, Kentucky, United States

    • Co-Author(s)

  • AK

    Alyssa K. Kabithe, Other

    Medical Student
    University of Louisville School of Medicine, USA

  • Iona MA Palmer, Bachelor of Arts

    Medical Student
    University of Louisville School of Medicine
    Anchorage, KY, United States

  • CA

    Christy Albert, Other

    Research Coordinator
    University of Louisville Department of Otolaryngology: Head & Neck Surgery & Communicative Disorders
    Louisville, KY, USA

  • Liz Cash, PhD

    Associate Professor, Director of Research
    University of Louisville Department of Otolaryngology: Head and Neck Surgery & Communicative Disorders
    Louisville, Kentucky, United States

    • Senior Author(s)

  • Liz Cash, PhD

    Associate Professor, Director of Research
    University of Louisville Department of Otolaryngology: Head and Neck Surgery & Communicative Disorders
    Louisville, Kentucky, United States

Disclosure(s):
Baylee R. Polzin, Other: No relevant relationships to disclose.
Iona MA Palmer, Bachelor of Arts: No relevant relationships to disclose.
Liz Cash, PhD: No relevant relationships to disclose.


Introduction: Head and neck malignancies correspond with higher rates of depressive symptoms compared to other cancers. We previously reported that depression is a significant prognostic factor for tumor response. We aim to expand previous research using a larger sample size and a more accurate depression screening. We hypothesize that greater depressive symptomology will predict poorer tumor response to treatment.

Methods: Recently diagnosed HNC patients presenting to a Multidisciplinary Clinic (n=208) between 2013 and 2020 reported depressive symptoms using the PHQ9 questionnaire at initial consult. Medical records were reviewed for clinical and demographic characteristics. Tumor response was assessed at six months post treatment completion and a dichotomous variable was created to indicate complete response vs. presence of a tumor including incomplete treatment response, residual tumor, early recurrence, or death. A logistic regression was used to test the hypothesis, while linear regression and Chi-square models were used for post hoc tests.

Results: Greater depressive symptomology was not associated with poorer tumor response (odds ratio = 1.006, 95% confidence interval, .955-1.055; P = .885). Males reported fewer depressive symptoms than females (Chi-square = 10.394, P = .001).

Conclusions: Depressive symptoms at initial consult did not predict tumor response, contradicting previous research. A post hoc analysis was conducted, considering the relationship between HPV status and depressive symptoms, predicting HPV + patients to have less depressive symptomology. We did not find these results to be significant. A control variable check showed male patients expressed significantly fewer depressive symptoms than females. Although females are twice as likely to be diagnosed with depression, males are four times as likely to die from suicide. Future studies should examine how to accurately determine depressive symptomology between genders to appropriately determine the relationship between depressive symptoms and tumor response.

Funding was provided by National Cancer Institute grant R25-CA134283.