Treatment- and Symptom-Related Determinants of Health-Related Quality of Life in Patients with Oropharyngeal Cancer

Background Oropharyngeal cancer, an oropharynx malignancy primarily linked to human papillomavirus infection, has seen substantial improvements with advances in treatment. However, many long-term survivors still experience functional impairments such as dysphagia and xerostomia that significantly reduce health-related quality of life (HRQoL). This study aims to identify treatment- and symptom-related factors associated with HRQoL in patients with oropharyngeal cancer. Methods This multicenter cross-sectional study enrolled 327 patients with oropharyngeal cancer from 14 hospitals in Korea. HRQoL was assessed using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) instrument, and independent variables were categorized into sociodemographic, clinical, and symptom-related domains. Descriptive statistics, t-tests, ANOVA, and multivariate linear regression were used to identify factors associated with HRQoL. Results The mean EQ-5D-5L index was 0.851 ± 0.141. Female patients exhibited significantly lower HRQoL than that of males (p = 0.022), while higher educational attainment and employment were associated with better HRQoL (p < 0.05). Robotic surgery correlated positively with HRQoL (β = 0.045, p = 0.025). Dyspnea, insomnia, dysphagia, social eating and contact difficulties, and trismus were independent predictors of poorer HRQoL. The final regression model accounted for 62.2% of the variance (R² = 0.622). Conclusions This study identified key determinants of HRQoL in patients with oropharyngeal cancer, emphasizing the influence of sex, education, robotic surgery, and symptom burden. Early integration of symptom-focused care is recommended, with particular emphasis on managing swallowing difficulties, insomnia, and social functioning. These findings underscore the need to incorporate HRQoL into survivorship programs and optimize treatment strategies that balance oncologic control with long-term quality of life.