title: An exploratory study of the influence of clinico-demographic variables on swallowing and swallowing-related quality of life in a cohort of oral and oropharyngeal cancer patients treated with primary surgery.
abstract: There are insufficient data on swallowing and the consequences of its dysfunction in patients with cancers of the oral cavity (OC) and oropharynx (OP) that are treated with primary surgery. The study attempts to explore the effect of important clinico-demographic variables on post-treatment swallowing and related quality of life (QOL) in post-surgical OC and OP cancer patients. Sixty-two consecutive OC and OP cancer patients completed the MD Anderson Dysphagia Inventory (MDADI) questionnaire. Mean scores were computed. Comparison of scores based on mean ranks were performed using Mann-Whitney U test or Kruskal-Wallis test. Level of significance was set at P ≤ 0.02. Adjustments were made for multiple comparisons. Significantly worse mean (SD) QOL scores were observed in late T-stage (T3/T4) versus early T-stage (T1/T2) patients for global domain, physical domain, functional domain and emotional domains [44.4 (21.9) vs. 78.7 (22.7) (P < 0.001); 50.0 (9.4) vs. 75.9 (16.3), (P < 0.0001); 57.8 (20.6) vs. 84.1 (16.7), (P < 0.001) and 55.2 (18.0) vs. 78.5 (16.3), (P < 0.001)], respectively. Patients undergoing reconstruction versus without reconstruction had worse QOL scores; 58.8 (26.9) versus 79.5 (22.8), (P < 0.01); 61.2 (15.1) versus 76.4 (17.5), (P = 0.002); 65.4 (20.5) versus 86.3 (15.9), (P < 0.0001) and 63.3 (18.8) versus 79.8 (16.3), (P < 0.01), respectively, for global, physical, functional and emotional domains. Advanced T-stage, reconstruction, younger age and base of tongue tumours have a negative impact on post-treatment swallow function and related QOL in these patients.
authors: Head and Neck Unit, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK. raghav_dwivedi@rediffmail.com
authors: Raghav C
authors: RC
authors: Dwivedi
authors: Edward J
authors: EJ
authors: Chisholm
authors: Afroze S
authors: AS
authors: Khan
authors: Nicholas J
authors: NJ
authors: Harris
authors: Shree A
authors: SA
authors: Bhide
authors: Suzanne
authors: S
authors: St Rose
authors: Cyrus J
authors: CJ
authors: Kerawala
authors: Peter M
authors: PM
authors: Clarke
authors: Christopher M
authors: CM
authors: Nutting
authors: Peter H
authors: PH
authors: Rhys-Evans
authors: Kevin J
authors: KJ
authors: Harrington
authors: Rehan
authors: R
authors: Kazi
mesh_terms: D003679:Deglutition / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery; D019647:Oral Surgical Procedures / Q000379:methods*; D009959:Oropharyngeal Neoplasms / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery; D011788:Quality of Life; D011795:Surveys and Questionnaires