Swallowing Disorders and Mortality in Adults with Advanced Cancer Outside the Head and Neck and Upper Gastrointestinal Tract: A Systematic Review

Abstract

Background Although oncological palliative care is increasingly being offered by multidisciplinary teams, there is still a lack of data about some symptoms handled by these teams, such as dysphagia, in patients with advanced cancer outside swallow regions. This study aimed to estimate the occurrence of dysphagia in prognosis studies of adults with advanced cancer outside the head, neck, and upper gastrointestinal tract, and to determine if there is an association with mortality. Methods A systematic review of studies that evaluated dysphagia and mortality was conducted (PROSPERO: CRD42021257172). Data sources: BVS, PubMed, CINAHL, Web of Science, and Scopus. Data between January 1, 2011 and June 30, 2021 were selected for the current study. Results Among the 408 articles screened, only 11 were included. Dysphagia demonstrated a variable frequency, and almost half of the studies found a percentage of dysphagia above 60%, appearing most as a symptom that affects health-related quality of life and prove to be a toxicity of treatment. The association between dysphagia and mortality was only evaluated in two articles that studied advanced lung cancer, in which, after controlling for covariates, swallowing disorders were associated with worse survival, with hazard ratios of 1.12 and 1.34. Conclusions The occurrence of dysphagia in advanced cancer outside anatomical swallowing regions is common, and there seems to be an association with significantly decreased survival in patients with advanced lung cancer.