title: Association between severity of dysphagia and survival in patients with head and neck cancer.
abstract: BACKGROUND
  This study examined risk factors for dysphagia, a common and serious condition in patients with head and neck cancer, and the association between severity of dysphagia and survival.
  
  
  METHODS
  Chart reviews were performed on patients diagnosed with head and neck cancer between January 2001 and April 2003, who had dysphagia diagnoses or swallowing evaluations. Regression analyses determined factors associated with dysphagia and the association between observed survival and severity of dysphagia.
  
  
  RESULTS
  Almost 50% of the 407 patients had dysphagia. Risk factors included advanced stage, older age, female sex, and hypopharyngeal tumors. The most severe dysphagia ([L.] nil per os or "nothing by mouth" status), which was associated with lower survival rates, was the strongest independent predictor of survival.
  
  
  CONCLUSIONS
  Swallowing problems should be considered when determining appropriate cancer-directed treatment and posttreatment care. Because of dysphagia's high incidence rate and association with survival, a speech-language pathologist should be involved to ensure routine diagnostic and therapeutic swallowing interventions.
authors: Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA.
authors: Samantha E
authors: SE
authors: Shune
authors: Lucy Hynds
authors: LH
authors: Karnell
authors: Michael P
authors: MP
authors: Karnell
authors: Douglas J
authors: DJ
authors: Van Daele
authors: Gerry F
authors: GF
authors: Funk
mesh_terms: D000367:Age Factors; D000368:Aged; D002277:Carcinoma / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors