title: Pretreatment Dysphagia Inventory and videofluorographic swallowing study as prognostic indicators of early survival outcomes in head and neck cancer.
abstract: BACKGROUND
  The prognostic role of swallowing-related, pretreatment subjective and objective findings has not been investigated in detail. The authors evaluated the association between pretreatment MD Anderson Dysphagia Inventory (MDADI) or videofluorographic swallowing study (VFSS) results and standard outcomes, including early recurrence and survival, in patients with treatment-naïve head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  Patients with HNSCC (n = 191) who received treatment at the authors' institution and were examined by self-administered MDADI questionnaires and VFSS were prospectively enrolled. MDADI and VFSS findings were analyzed in correlation with clinicopathologic variables, and factors that predicted 2-year disease-free survival (DFS) and overall survival (OS) were identified using a Cox proportional-hazards regression model.
  
  
  RESULTS
  The 2-year OS and DFS rates were 80.1% and 77.5%, respectively. Clinical tumor (T) and lymph node (N) classifications, overall TNM stage, sex, tumor site, and educational level were significantly associated with specific MDADI subdomains, whereas Karnofsky performance score was significantly associated with all MDADI subdomains. After controlling for clinical factors, total scores, global assessment scores, and emotional and physical MDADI subscores were significantly predictive of 2-year OS and DFS (P < .05 for each). VFSS findings were not significantly associated with survival (P > .05).
  
  
  CONCLUSIONS
  The current results provide evidence of the prognostic role of the MDADI in predicting early survival outcomes in patients with HNSCC. The MDADI may be a practical and noninvasive method for the identification of patients at risk who would benefit from close follow-up.
authors: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors: Chan Joo
authors: CJ
authors: Yang
authors: Jong-Lyel
authors: JL
authors: Roh
authors: Kyoung Hyo
authors: KH
authors: Choi
authors: Min-Ju
authors: MJ
authors: Kim
authors: Seung-Ho
authors: SH
authors: Choi
authors: Soon Yuhl
authors: SY
authors: Nam
authors: Sang Yoon
authors: SY
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D018572:Disease-Free Survival; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011856:Radiographic Image Enhancement; D018570:Risk Assessment; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014741:Video Recording; D015431:Weight Loss
keywords: MD Anderson Dysphagia Inventory; head and neck squamous cell carcinoma; quality of life; survival; videofluorographic swallowing study