Swallowing Outcomes for T1‐T4 Oropharyngeal Cancers Treated with TORS: Preliminary Experience

Abstract

Objectives: 1) Assess swallowing function longitudinally using standardized questionnaires in a cohort of oropharyngeal cancer patients treated with transoral robotic surgery (TORS). 2) Compare the effect of tumor T-stage on swallowing outcomes. Methods: A prospective, institutional review board (IRB)-approved database of all patients undergoing TORS for oropharyngeal cancer at a tertiary-care academic institution was queried from November 2010-October 2012. Demographic data as well as longitudinal assessment of swallowing outcomes were collected. Standardized questionnaires included: University of Washington Quality of Life question 5 (UW-QOLq5), MD Anderson Dysphagia Inventory (MDADI), and Functional Oral Intake Scale (FOIS). Two-sided Wilcoxon signed-rank tests were used to compare baseline values with corresponding 1, 3, 6, and 12 months post-surgery. Two-sided Wilcoxon rank-sum tests were used to test for differences between T-stages. Results: Thirty-nine patients were studied with a mean age of 60.7 (42-92). T-stages included: T1 n = 14, T2 n = 15, T3 n = 6, T4 n = 4. No significant differences were detected at any time between patients with T1-T2 and T3-T4 stage disease on UW-QOLq5, MDADI, or FOIS. Compared to baseline, UW-QOLq5 measures were significantly lower at 1 month ( P = 0.0156), but not at 3 or 6 months. MDADI overall scores were significantly lower than baseline at 1 month ( P = 0.0134), but not at 3, 6, or 12 months. Compared to baseline, FOIS measures were significantly lower at 1 month ( P <.0001), and remained significantly lower at 3 ( P <.0001), 6 ( P <.0001), and 12 months ( P = 0.0039). Conclusions: Results suggests that while swallowing status declines immediately after TORS, it can be expected to approach baseline within 3 months post-surgery.