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

Publication ,  Journal Article
Lee, E; Gorelik, D; Crowder, HR; Badger, C; Schottler, J; Li, N-W; Siegel, R; Sadeghi, N; Goodman, JF; Thakkar, PG; Joshi, AS
Published in: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
August 2022

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).Retrospective analysis of patients with OPSCC treated with NAC+S between 2010 and 2021.A single academic institution.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.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 (P = .036) and lower clinical TNM stage (P = .04), as well as higher composite, emotional, functional, and physical MDADI scores (P = .017, .046, .013, and .05, respectively).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.

Duke Scholars

Published In

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

DOI

EISSN

1097-6817

ISSN

0194-5998

Publication Date

August 2022

Volume

167

Issue

2

Start / End Page

298 / 304

Related Subject Headings

  • Robotic Surgical Procedures
  • Retrospective Studies
  • Papillomavirus Infections
  • Otorhinolaryngology
  • Oropharyngeal Neoplasms
  • Neoplasm Recurrence, Local
  • Neoadjuvant Therapy
  • Male
  • Humans
  • Follow-Up Studies
 

Citation

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Lee, E., Gorelik, D., Crowder, H. R., Badger, C., Schottler, J., Li, N.-W., … Joshi, A. S. (2022). Swallowing Function Following Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharyngeal Carcinoma: A 2-Year Follow-up. Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 167(2), 298–304. https://doi.org/10.1177/01945998211057430
Lee, Esther, Daniel Gorelik, Hannah R. Crowder, Christopher Badger, Jennifer Schottler, Ning-Wei Li, Robert Siegel, et al. “Swallowing Function Following Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharyngeal Carcinoma: A 2-Year Follow-up.Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery 167, no. 2 (August 2022): 298–304. https://doi.org/10.1177/01945998211057430.
Lee E, Gorelik D, Crowder HR, Badger C, Schottler J, Li N-W, et al. Swallowing Function Following Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharyngeal Carcinoma: A 2-Year Follow-up. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 2022 Aug;167(2):298–304.
Lee, Esther, et al. “Swallowing Function Following Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharyngeal Carcinoma: A 2-Year Follow-up.Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 167, no. 2, Aug. 2022, pp. 298–304. Epmc, doi:10.1177/01945998211057430.
Lee E, Gorelik D, Crowder HR, Badger C, Schottler J, Li N-W, Siegel R, Sadeghi N, Goodman JF, Thakkar PG, Joshi AS. Swallowing Function Following Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharyngeal Carcinoma: A 2-Year Follow-up. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 2022 Aug;167(2):298–304.
Journal cover image

Published In

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

DOI

EISSN

1097-6817

ISSN

0194-5998

Publication Date

August 2022

Volume

167

Issue

2

Start / End Page

298 / 304

Related Subject Headings

  • Robotic Surgical Procedures
  • Retrospective Studies
  • Papillomavirus Infections
  • Otorhinolaryngology
  • Oropharyngeal Neoplasms
  • Neoplasm Recurrence, Local
  • Neoadjuvant Therapy
  • Male
  • Humans
  • Follow-Up Studies