title: Impact of neck dissection on long-term feeding tube dependence in patients with head and neck cancer treated with primary radiation or chemoradiation.
abstract: BACKGROUND
  The impact of posttreatment neck dissection on prolonged feeding tube dependence in patients with head and neck squamous cell cancer (HNSCC) treated with primary radiation or chemoradiation remains unknown.
  
  
  METHODS
  We conducted a retrospective cohort study using propensity score adjustment to investigate the effect of neck dissection on prolonged feeding tube dependence.
  
  
  RESULTS
  A review of 67 patients with node-positive HNSCC (T1-4N1-3), treated with primary radiation or chemoradiation, with no evidence of tumor recurrence and follow-up of at least 24 months, was performed. Following adjustment for covariates, the relative risk (RR) of feeding tube dependence at 18 months was significantly increased in patients treated with posttreatment neck dissection (RR 4.74, 95% confidence interval [CI] 2.07-10.89). At 24 months, the relative risk of feeding tube dependence in the patients having undergone neck dissection increased further (RR 7.66, 95% CI 2.07-10.89). Of patients with feeding tubes 2 years after completing treatment, 75% remained feeding tube dependent.
  
  
  CONCLUSIONS
  Neck dissection may contribute to chronic oropharyngeal dysphagia in HNSCC patients treated with primary radiation or chemoradiation.
authors.affiliation: Department of Surgical Oncology, Head and Neck Section, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA. Miriam.Lango@fccc.edu
authors.forename: Miriam N
authors.initials: MN
authors.lastname: Lango
authors.forename: Brian
authors.initials: B
authors.lastname: Egleston
authors.forename: Kevin
authors.initials: K
authors.lastname: Ende
authors.forename: Steven
authors.initials: S
authors.lastname: Feigenberg
authors.forename: David J
authors.initials: DJ
authors.lastname: D'Ambrosio
authors.forename: Roger B
authors.initials: RB
authors.lastname: Cohen
authors.forename: Sidrah
authors.initials: S
authors.lastname: Ahmad
authors.forename: Nicos
authors.initials: N
authors.lastname: Nicolaou
authors.forename: John A
authors.initials: JA
authors.lastname: Ridge
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004750:Enteral Nutrition; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D018579:Patient Selection; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
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