Human papilloma virus-related oropharyngeal cancer

Goldsmith, Tessa; Roe, Justin

doi:10.1097/moo.0000000000000154

Cited by 11 publications

References 45 publications

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Swallowing‐related outcomes associated with late lower cranial neuropathy in long‐term oropharyngeal cancer survivors: cross‐sectional survey analysis

et al. 2019

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Background The purpose of this study was to quantify the association of late lower cranial neuropathy (late LCNP) with swallowing‐related quality of life (QOL) and functional status among long‐term oropharyngeal cancer (OPC) survivors. Methods Eight hundred eighty‐nine OPC survivors (median survival time: 7 years) who received primary treatment at a single institution between January 2000 and December 2013 completed a cross‐sectional survey (56% response rate) that included the MD Anderson Dysphagia Inventory (MDADI) and self‐report of functional status. Late LCNP events ≥3 months after cancer therapy were abstracted from medical records. Multivariate models regressed MDADI scores on late LCNP status adjusting for clinical covariates. Results Overall, 4.0% (n = 36) of respondents developed late LCNP with median time to onset of 5.25 years post‐treatment. LCNP cases reported significantly worse mean composite MDADI (LCNP: 68.0 vs no LCNP: 80.2; P < .001). Late LCNP independently associated with worse mean composite MDADI (β = −6.7, P = .02; 95% confidence interval [CI], −12.0 to −1.3) as well as all MDADI domains after multivariate adjustment. LCNP cases were more likely to have a feeding tube at time of survey (odds ratio [OR] = 20.5; 95% CI, 8.6‐48.9), history of aspiration pneumonia (OR = 23.5; 95% CI, 9.6‐57.6), and tracheostomy (OR = 26.9; 95% CI, 6.0‐121.7). Conclusions In this large survey study, OPC survivors with late LCNP reported significantly poorer swallowing‐related QOL and had significantly higher likelihood of poor functional status. Further efforts are necessary to optimize swallowing outcomes to improve QOL in this subgroup of survivors.

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