Factors affecting swallow outcome following treatment for advanced oral and oropharyngeal malignancies

Head Neck. 2014 Jan;36(1):47-54. doi: 10.1002/hed.23262. Epub 2013 Apr 4.

Abstract

Background: Treatment for tumors of the oral cavity and the oropharynx disrupts normal swallow function. The ability for oral diet postoperatively varies and may be influenced by surgery and patient-related factors.

Methods: In all, 114 patients treated with surgery with and without chemoradiotherapy for advanced oral/oropharyngeal cancer were recruited. Clinicopathologic tumor parameters and reconstruction modalities were recorded. Swallow function was determined by oral intake, using the Functional Oral Intake Scale (FOIS) pretreatment and posttreatment.

Results: The median time to first attaining swallow function was 14 days. Patients were less likely to attain tube independence within 1 year of surgery if they received radiotherapy or had a low FOIS score preoperatively. Patients' time to first attaining swallow function postsurgery was inversely related to the FOIS score presurgery.

Conclusions: Swallow function recovery postsurgery is better in patients with higher FOIS presurgery, smaller tumors, and no requirement for radiotherapy.

Keywords: head and neck cancer; oral cancer; radiotherapy; reconstruction; swallow.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy / adverse effects*
  • Chemoradiotherapy / methods
  • Cohort Studies
  • Combined Modality Therapy
  • Deglutition Disorders / diagnosis
  • Deglutition Disorders / epidemiology*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Middle Aged
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / therapy*
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / therapy*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Sex Factors
  • Survival Analysis
  • Treatment Outcome
  • Young Adult