Swallowing Function Following Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharyngeal Carcinoma: A 2-Year Follow-up

Esther Lee, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Daniel Gorelik, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Hannah R. Crowder, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Christopher Badger, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Jennifer Schottler, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Ning-Wei Li, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Robert Siegel, Division of Hematology and Oncology, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Nader Sadeghi, Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Canada.
Joseph F. Goodman, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Punam G. Thakkar, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Arjun S. Joshi, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.

Document Type

Journal Article

Publication Date

8-1-2022

Journal

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

Volume

167

Issue

2

DOI

10.1177/01945998211057430

Keywords

MD Anderson Dysphagia Inventory (MDADI); neoadjuvant chemotherapy; oropharyngeal squamous cell carcinoma; swallowing; transoral robotic surgery

Abstract

OBJECTIVE: To evaluate 2-year follow-up swallowing function in patients with human papillomavirus-related oropharyngeal squamous cell carcinoma (HPV+ OPSCC) who completed neoadjuvant chemotherapy and transoral robotic surgery (NAC+S). STUDY DESIGN: Retrospective analysis of patients with OPSCC treated with NAC+S between 2010 and 2021. SETTING: A single academic institution. METHODS: This is a cross-sectional study of patient-reported swallowing function, assessed with the MD Anderson Dysphagia Inventory (MDADI) at least 2 years after completion of treatment. The inclusion criteria are patients with HPV+ OPSCC who underwent NAC+S at least 2 years ago. Those requiring adjuvant radiation or chemoradiation or experiencing relapse were excluded from the study. RESULTS: Completed MDADIs were received from 37 patients at a median 3.8 years posttreatment (interquartile range, 2.0-8.6 years). Of those, 94.6% (n = 35) were male and 81.1% (n = 30) were White. The median age at OPSCC diagnosis was 59.0 years (interquartile range, 41-80 years). The most frequent primary subsite of OPSCC was the base of the tongue (n = 20, 54.1%), followed by the tonsils (n = 16, 43.2%). In addition, 75.7% (n = 28) had stage IVa disease (TNM seventh edition), and 29 (78.4%) had scores ≥80, classified as optimal function. When compared with patients who received bilateral neck dissection, patients who received unilateral neck dissection were associated with an age <65 years old ( = .036) and lower clinical TNM stage ( = .04), as well as higher composite, emotional, functional, and physical MDADI scores ( = .017, .046, .013, and .05, respectively). CONCLUSION: Patients with OPSCC who were treated with NAC+S achieved satisfactory long-term swallowing outcomes. Unilateral neck dissection was significantly associated with higher MDADI scores in this patient cohort.

Department

Medicine

Link to Full Text

Share

COinS