title: Weight loss and body mass index in relation to aspiration in patients treated for head and neck cancer: a long-term follow-up.
abstract: OBJECTIVE
  Persistent severe swallowing dysfunction with aspiration is a common and sometimes overlooked sequelae after treatment for squamous cell carcinoma of the head and neck (SCCHN) and may impact food intake and nutritional status. More knowledge is needed to increase the understanding of severe swallowing dysfunction as a risk factor for persistent nutritional deteriorations in SCCHN survivors. The purpose of the study was to investigate weight loss and body mass index (BMI) in relation to pharyngeal swallowing function in a long-term perspective in patients after SCCHN treatment.
  
  
  METHODS
  Data from 101 patients were available for the analyses. Swallowing function was assessed by videofluoroscopy at a mean of 71.6 months after the start of radiotherapy (RT). Percent weight change (calculated with weight at the start of RT as the reference) and BMI at follow-up were the primary nutritional measures.
  
  
  RESULTS
  Aspiration was present in 48 of 101 patients (48 %). Patients with aspiration had a significantly higher mean weight loss and a lower BMI (-10.9 % and 23.1, respectively) at follow-up compared with patients without aspiration (-2.8 % and 26.0, respectively). Patients with aspiration were unable to gain weight after 23 months. Only ten of 101 patients (10 %) were underweight at follow-up.
  
  
  CONCLUSIONS
  Swallowing dysfunction with aspiration was related to long-term weight loss and reduced BMI. Few patients were underweight despite the high prevalence of swallowing dysfunction.
authors.affiliation: Department of Clinical Sciences, Otorhinolaryngology, Umeå University, 901 87, Umeå, Sweden, sandra.ottosson@kost.umu.se.
authors.forename: Sandra
authors.initials: S
authors.lastname: Ottosson
authors.forename: Ulrika
authors.initials: U
authors.lastname: Lindblom
authors.forename: Peter
authors.initials: P
authors.lastname: Wahlberg
authors.forename: Per
authors.initials: P
authors.lastname: Nilsson
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kjellén
authors.forename: Björn
authors.initials: B
authors.lastname: Zackrisson
authors.forename: Eva
authors.initials: E
authors.lastname: Levring Jäghagen
authors.forename: Göran
authors.initials: G
authors.lastname: Laurell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology / Q000532:radiotherapy*; D003679:Deglutition / Q000502:physiology / Q000528:radiation effects; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000150:complications*; D053120:Respiratory Aspiration / Q000209:etiology*; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck; D017741:Survivors; D015431:Weight Loss