A longitudinal study of the Swedish MD Anderson Dysphagia Inventory in patients with oral cancer

Abstract

Objective: The aim of this study was to investigate whether the Swedish MD. Anderson Dysphagia Inventory (MDADI) is able to detect changes in dysphagia symptoms over time for patients with head and neck cancer (HNC). Methods: One hundred and forty-two patients with resectable tumors of the oral cavity were included prior to treatment. The patients filled out the MDADI, European Organization for Research and Treatment of Cancer Quality of Life questionnaire Core 30 (EORTC QLQ-C30) and the HNC module (H&N35) at baseline and at least one follow-up at 6 and/or 12 months after oncologic treatment. A control group without dysphagia (n = 115) was included. Results: Self-perceived swallowing function decreased in all domains at 6 months, and improved between 6 and 12 months. The changes were similar to the changes of the EORTC domains, indicating a sensitivity to change. However, even if improvements were seen at 12 months, the values were still inferior compared to baseline values, and the values of a control group without dysphagia. Convergent validity was found with values of the MDADI and EORTC domains producing similar results, and moderate correlations as hypothesized. Patients with moderate-severe dysphagia according to the MDADI (<60 points) demonstrated inferior values of the EORTC domains compared to patients with scores above 60 points. Conclusion: The Swedish MDADI was found to be sensitive to change, and showed convergent results when compared to other established instruments. The threshold value for the MDADI (<60 points) indicating moderate-severe dysphagia may be a valuable addition in the clinical use.

The effect of the Shaker head‐lift exercise on swallowing function following treatment for head and neck cancer: Results from a randomized, controlled trial with videofluoroscopic evaluation

“…Dysphagia also has negative consequences on a patient's medical recovery and may lead to prolonged hospitalization and long‐term care 23 . Additionally, swallowing difficulties enhance the risk of malnutrition and mortality and reduce the health‐related quality of life (HRQL) 4,24–28 …”

“… 23 Additionally, swallowing difficulties enhance the risk of malnutrition and mortality and reduce the health‐related quality of life (HRQL). 4 , 24 , 25 , 26 , 27 , 28 …”

Perioperative change trajectories and predictors of swallowing function and swallowing-related quality of life in patients with oral cancer: a longitudinal observational study

“…7–9 Current evidence suggests that swallowing function and swallowing-related QoL, as evaluated using the MDADI, are dynamic variables. 8 10 11 For example, a previous study conducted among patients with head and neck cancer undergoing radiotherapy has reported that dysphagia rates were 5.7% prior to radiotherapy, 69.7% in the third week of radiotherapy and 77.9% at the completion of radiotherapy. 11 Another study conducted among patients after treatment for oral cancer has shown that MDADI scores decreased at 6 months and increased between 6 and 12 months; however, scores at 12 months remained inferior to those recorded at baseline.…”

“… 11 Another study conducted among patients after treatment for oral cancer has shown that MDADI scores decreased at 6 months and increased between 6 and 12 months; however, scores at 12 months remained inferior to those recorded at baseline. 8 To date, few studies have investigated changes in the swallowing function and swallowing-related QoL in perioperative patients with oral cancer.…”

Perioperative symptom burden and its influencing factors in patients with oral cancer: A longitudinal study

“…5 The literature showed that 10% of patients with oral cancer had moderate to severe dysphagia before treatment, and 27% had moderate to severe dysphagia 6 months after treatment, and their swallowing functions failed to reach the baseline level at 1-year posttreatment. 6 The severity of symptoms in oral cancer patients is affected by a variety of factors. Hasegawa et al reported that advanced tumor stage, bilateral neck dissection, and the resection of unilateral or bilateral suprahyoid muscles were associated with the severity of dysphagia in oral cancer patients.…”