Aspiration, weight loss, and quality of life in head and neck cancer survivors.
OBJECTIVE
To determine associations between objective assessments (swallowing function and weight change) and subjective quality-of-life (QOL) measures.


METHODS
Observational case series using clinical testing and questionnaires.


METHODS
University hospital-based tertiary clinical practice.


METHODS
Convenience sample of 5-year survivors of head and neck cancer (62 nonlaryngectomy survivors were studied).


METHODS
Objective testing included examination, weight history, videofluoroscopic swallow studies (VFSS), and oropharyngeal swallowing efficiency (OPSE). Subjective testing included QOL questionnaires (University of Washington Quality-of-Life [UWQOL] Scale, Performance Status Scale for Head and Neck Cancer Patients [PSS-HN], Functional Assessment of Cancer Treatment-General [FACT-G] Scales, and Functional Assessment of Cancer Therapy-Head and Neck [FACT-H&N] Scale).


METHODS
Aspiration (identified by VFSS), weight change, and QOL measures.


RESULTS
Aspiration was associated with the decreased QOL scores in chewing, swallowing, normalcy of diet, and additional concerns of the FACT-H&N Scale. No association was found between aspiration and willingness to eat in public, subjective understandability, or any of the FACT-G scales. Of the nonlaryngectomy survivors, 27 (44%) demonstrated some degree of aspiration during VFSS. Associations were found between aspiration, primary tumor T stage, weight change, and OPSE. Aspirators lost a mean of 10.0 kg from precancer treatment weight, while nonaspirators gained a mean of 2.3 kg (P<.001). Mean OPSE scores were 69 for nonaspirators and 53 for aspirators (P =.01).


CONCLUSIONS
Almost half of long-term nonlaryngectomy head and neck cancer survivors demonstrated at least some degree of aspiration. The presence of aspiration is associated with substantial weight loss, advanced initial tumor stage, diminished oropharyngeal swallowing efficiency, and lower scores on a variety of QOL scales.
Campbell
Bruce H
BH
Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee 53226-3522, USA. bcampbel@mcw.edu
Spinelli
Kristine
K
Marbella
Anne M
AM
Myers
Katherine B
KB
Kuhn
Joan C
JC
Layde
Peter M
PM
D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D017741:Survivors; D015431:Weight Loss; D014922:Wisconsin / Q000453:epidemiology