Functional Swallowing Outcomes in Transoral Robotic Surgery Patients With and Without Adjuvant Treatment

Caitlin Coviello,Alejandro Mantero,Giovana Thomas,Donna Lundy,Mario Landera,Jamal Ahmed,Opeoluwa Daniyan,Carlos Green

doi:10.24983/scitemed.aohns.2020.00127

Caitlin Coviello, Alejandro Mantero + Show 6 more

Open Access

https://doi.org/10.24983/scitemed.aohns.2020.00127

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Abstract

Dysphagia is an important consequence of cancer treatment and has overarching implications on quality of life. Using the FOIS, we demonstrated that swallowing function may be worse in the long term in patients with OPSCC undergoing triple therapy, although this finding did not reach statistical significance. This study emphasizes the importance of diligent selection in patients undergoing TORS to avoid poor functional swallowing outcomes, particularly in those that may need adjuvant chemoradiation therapy. A study with a larger sample size may determine the significance of these trends.

Highlights

Human Papilloma Virus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is rapidly becoming the most commonly diagnosed head and neck malignancy [1,2] and its prevalence is expected to continue to increase in the coming years [3,4]
HPV-related OPSCC patients are often younger with longer overall life expectancies [23,24]; avoiding long-term sequelae of therapy has become an important issue in this patient population [25]
Dysphagia is an important consequence of cancer treatment and has overarching implications on quality of life

Summary

Introduction

Human Papilloma Virus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is rapidly becoming the most commonly diagnosed head and neck malignancy [1,2] and its prevalence is expected to continue to increase in the coming years [3,4]. Favorable swallowing outcomes have been reported following single modality treatment with TORS [26], research has shown that many patients require post-operative adjuvant radiation or chemoradiation due to unforeseen negative prognostic factors discovered in their resected tumor or neck specimen [27]. These adjuvant treatments are thought to further impact acute and late toxicities, can result in fibrosis and scarring, and have negative effects on swallowing safety and efficiency [25,28]. FOIS is a clinician-rated scale based on a patient’s report of oral intake and provides clinicians a better understanding of a patient’s functional ability [31]

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Conclusion