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An exploratory study of the influence of clinico-demographic variables on swallowing and swallowing-related quality of life in a cohort of oral and oropharyngeal cancer patients treated with primary surgery

  • Head and Neck
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Abstract

There are insufficient data on swallowing and the consequences of its dysfunction in patients with cancers of the oral cavity (OC) and oropharynx (OP) that are treated with primary surgery. The study attempts to explore the effect of important clinico-demographic variables on post-treatment swallowing and related quality of life (QOL) in post-surgical OC and OP cancer patients. Sixty-two consecutive OC and OP cancer patients completed the MD Anderson Dysphagia Inventory (MDADI) questionnaire. Mean scores were computed. Comparison of scores based on mean ranks were performed using Mann–Whitney U test or Kruskal–Wallis test. Level of significance was set at P ≤ 0.02. Adjustments were made for multiple comparisons. Significantly worse mean (SD) QOL scores were observed in late T-stage (T3/T4) versus early T-stage (T1/T2) patients for global domain, physical domain, functional domain and emotional domains [44.4 (21.9) vs. 78.7 (22.7) (P < 0.001); 50.0 (9.4) vs. 75.9 (16.3), (P < 0.0001); 57.8 (20.6) vs. 84.1 (16.7), (P < 0.001) and 55.2 (18.0) vs. 78.5 (16.3), (P < 0.001)], respectively. Patients undergoing reconstruction versus without reconstruction had worse QOL scores; 58.8 (26.9) versus 79.5 (22.8), (P < 0.01); 61.2 (15.1) versus 76.4 (17.5), (P = 0.002); 65.4 (20.5) versus 86.3 (15.9), (P < 0.0001) and 63.3 (18.8) versus 79.8 (16.3), (P < 0.01), respectively, for global, physical, functional and emotional domains. Advanced T-stage, reconstruction, younger age and base of tongue tumours have a negative impact on post-treatment swallow function and related QOL in these patients.

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Acknowledgments

This work was undertaken in The Royal Marsden NHS Foundation Trust who received a proportion of its funding from the NHS Executive; the views expressed in this publication are those of the authors and not necessarily those of the NHS Executive. This work was supported by the Institute of Cancer Research, and Cancer Research UK Section of Radiotherapy [CRUK] grant number C46/A10588. We acknowledge NHS funding to the NIHR Biomedical Research Centre. Dr. Raghav Dwivedi and Dr. Rehan Kazi are supported by Research Grants from the Head and Neck Cancer Research Trust/The Oracle Cancer Trust.

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Authors and Affiliations

  1. Head and Neck Unit, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK

    Raghav C. Dwivedi, Edward J. Chisholm, Afroze S. Khan, Shree A. Bhide, Cyrus J. Kerawala, Peter M. Clarke, Christopher M. Nutting, Peter H. Rhys-Evans, Kevin J. Harrington & Rehan Kazi

  2. The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK

    Raghav C. Dwivedi, Shree A. Bhide, Christopher M. Nutting, Peter H. Rhys-Evans, Kevin J. Harrington & Rehan Kazi

  3. Department of ENT and Head-Neck Surgery, Whipps Cross University Hospital, London, E11 1NR, UK

    Raghav C. Dwivedi & Nicholas J. Harris

  4. Research, Data and Statistical Unit, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK

    Suzanne St.Rose

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  1. Raghav C. Dwivedi
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  2. Edward J. Chisholm
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Correspondence to Raghav C. Dwivedi.

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Dwivedi, R.C., Chisholm, E.J., Khan, A.S. et al. An exploratory study of the influence of clinico-demographic variables on swallowing and swallowing-related quality of life in a cohort of oral and oropharyngeal cancer patients treated with primary surgery. Eur Arch Otorhinolaryngol 269, 1233–1239 (2012). https://doi.org/10.1007/s00405-011-1756-y

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  • DOI: https://doi.org/10.1007/s00405-011-1756-y

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