title: Transoral laser microsurgery ± adjuvant therapy versus chemoradiotherapy for stage III and IVA oropharyngeal squamous cell carcinoma: Preliminary comparison of early swallowing outcomes.
abstract: BACKGROUND
  Observational data suggests transoral surgery may offer benefit in swallowing over chemoradiotherapy.
  
  
  METHODS
  In this preliminary, non-randomized study, patients with stage III and IVA oropharyngeal carcinoma treated with transoral laser microsurgery (TLM) were assessed pretreatment and 3 months after treatment using the MD Anderson Dysphagia Inventory (MDADI), the Performance Status Scale (PSS), and a timed Water Swallow Test (WST). Comparisons were made with a historical chemoradiotherapy (CRT) cohort.
  
  
  RESULTS
  Based on patients with measurements at both times, the decrease in score between baseline and 3 months was greater for CRT patients (n = 26-28) than for TLM (n = 20-21) patients for each of MDADI, PSS, and WST. A repeated measures analysis that looked at all 3 scores simultaneously and allowed for missing values gave mostly similar results (except for MDADI).
  
  
  CONCLUSIONS
  TLM was associated with good early swallowing outcomes at 3 months and may offer a benefit over CRT. The results should be viewed as preliminary data, providing useful reference for any proposed controlled trial.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Sunderland Royal Hospital and Institute of Health and Society, Newcastle University, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: O'Hara
authors.affiliation: Academic Foundation, Newcastle upon Tyne NHS Foundation Trust and Associate Clinical Research, Newcastle University, United Kingdom.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Cosway
authors.affiliation: Medical Statistics, Institute of Health and Society, Newcastle University, United Kingdom.
authors.forename: Colin
authors.initials: C
authors.lastname: Muirhead
authors.affiliation: Department of Speech and Language Therapy, Sunderland Royal Hospital, United Kingdom.
authors.forename: Nicola
authors.initials: N
authors.lastname: Leonard
authors.affiliation: Department of Speech and Language Therapy, Sunderland Royal Hospital, United Kingdom.
authors.forename: Diane
authors.initials: D
authors.lastname: Goff
authors.affiliation: Department of Speech and Language Therapy, Sunderland Royal Hospital, United Kingdom.|Institute of Health and Society, Newcastle University, United Kingdom.
authors.forename: Joanne
authors.initials: J
authors.lastname: Patterson
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D003131:Combined Modality Therapy; D003679:Deglutition; D003680:Deglutition Disorders / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
keywords: chemoradiotherapy; oropharyngeal squamous cell carcinoma; swallowing; transoral surgery