Prediction of Speech, Swallowing, and Quality of Life in Oral Cavity Cancer Patients: A Pilot Study
| Autor: | Joseph Zenga, Daniel G. Deschler, Mustafa G. Bulbul, Kevin S. Emerick, Jeremy D. Richmon, Sidharth V. Puram, Tessa Goldsmith, Mark A. Varvares, Michael P Wu, Derrick T. Lin |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Oral Surgical Procedures Pilot Projects Risk Assessment Speech Disorders 03 medical and health sciences Young Adult 0302 clinical medicine Quality of life Swallowing Tongue Adjuvant therapy Medicine Humans Speech Prospective Studies 030223 otorhinolaryngology Prospective cohort study Aged Retrospective Studies Aged 80 and over Performance status business.industry Retrospective cohort study Chemoradiotherapy Adjuvant Middle Aged Prognosis Dysphagia Deglutition medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Physical therapy Quality of Life Female Mouth Neoplasms medicine.symptom business Deglutition Disorders |
| Zdroj: | The LaryngoscopeREFERENCES. 131(11) |
| ISSN: | 1531-4995 |
| Popis: | OBJECTIVES/HYPOTHESIS To investigate the impact of specific treatment-related variables on functional and quality of life outcomes in oral cavity cancer (OCC) patients. STUDY DESIGN Retrospective Cohort. METHODS Patients with primary OCC at least 6 months after resection and adjuvant therapy were included. Patients completed surveys including the Speech Handicap Index (SHI), M.D. Anderson Dysphagia Inventory (MDADI), and Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN). Performance Status Scale (PSS) and tongue mobility scale were completed to allow provider-rated assessment of speech and tongue mobility, respectively. Additional details regarding treatment were also collected. These data were used to generate a predictive model using linear regression. RESULTS Fifty-three patients with oral tongue and/or floor of mouth (FOM) resection were included in our study. In multivariable analysis, greater postoperative tongue range of motion (ROM) and time since treatment improved SHI. Flap reconstruction and greater postoperative tongue ROM increased MDADI and PSS (eating and speech). A larger volume of resected tissue was inversely correlated with PSS (diet and speech). Tumor site was an important predictor of PSS (all sections). There were no statistically significant predictors of FACT-HN. CONCLUSIONS In this pilot study, we propose a battery of tools to assess function in OCC patients treated with surgery. Using the battery of tools we propose, our results show that a surgical endpoint that preserves tongue mobility and employs flap reconstruction resulted in better outcomes, whereas those with greater volume of tissue resected and FOM involvement resulted in poorer outcomes. Larger prospective studies are needed to validate our findings. LEVEL OF EVIDENCE 3 Laryngoscope, 131:2497-2504, 2021. |
| Databáze: | OpenAIRE |
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