Abstract
BackgroundThis prospective study investigated the change of swallowing ability using the Swallowing Ability Scale System (SASS) and swallowing-related quality of life (QOL) by Performance Status Scale for Head and Neck Cancer patients (PSS-H&N). This study also investigated the risk factors for postoperative dysphagia in patients who received reconstructive surgery for oral cancer.Subjects and MethodsThis study included 64 patients (33 men and 31 women) who underwent radical surgery with neck dissection and reconstructive surgery for oral cancers between July 2014 and February 2018. We evaluated risk factors for poor swallowing ability after treatment, including demographic factors, preoperative factors and perioperative factors, with univariate and multivariate analyses. The change of swallowing ability by the SASS and swallowing-related QOL by PSS-H&N were evaluated prospectively prior to the initiation of surgery within 1 week and at 1 and 3 months after treatment.ResultsAdvanced T stage (T3, 4) (odds ratio (OR) = 79.71), bilateral neck dissection (OR = 20.66) and the resection of unilateral or bilateral suprahyoid muscles (OR = 17.00) were associated with poor swallowing ability after treatment. The scores for time for food intake and Eating in Public were associated with decrease of QOL in the poor group.ConclusionsWe propose that clinicians consider the risk factors identified in this study and pay close attention to the management of oral cancer patients with reconstructive surgery.Graphical abstract
Highlights
The treatment strategies for oral cancer have been improving and have reduced postoperative mortality and increased the survival rate of oral cancer patients [1]
We propose that clinicians consider the risk factors identified in this study and pay close attention to the management of oral cancer patients with reconstructive surgery
With regard to the operative factors according to T stage, there was no significant difference between advanced T stage and extensive neck dissection, extensive resection of suprahyoid muscle, and adjacent organs
Summary
The treatment strategies for oral cancer have been improving and have reduced postoperative mortality and increased the survival rate of oral cancer patients [1]. Clinical evaluations are widely performed by various functional tests [7] These tests that conduct subjective evaluation include grading systems such as the Swallowing Ability Scale System (SASS) [14], the M.D. Anderson Dysphagia Inventory [15], the Performance Status Scale for Head and Neck Cancer patients (PSS-H&N) [16], and the Functional Assessment of Cancer Therapy-H&N (FACTH&N) [17]. The SASS is useful for bedside evaluation because the test is simple and easy and can evaluate by referring to actual feeding condition This prospective study investigated the change of swallowing ability using the Swallowing Ability Scale System (SASS) and swallowing-related quality of life (QOL) by Performance Status Scale for Head and Neck Cancer patients (PSS-H&N). This study investigated the risk factors for postoperative dysphagia in patients who received reconstructive surgery for oral cancer
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