title: Baseline swallowing measures predict recovery at 6 weeks after transoral robotic surgery for head and neck cancer.
abstract: OBJECTIVE
  To explore whether pre-treatment swallowing measures predict swallowing recovery at 6 weeks after transoral robotic surgery (TORS).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Tertiary care cancer centre in the United Kingdom.
  
  
  METHODS
  Fifty-one consecutive patients undergoing TORS for head and neck cancer, between April 2013 and February 2015.
  
  
  METHODS
  Swallowing function assessed by Performance Status Scale (PSS) Normalcy of Diet, timed water swallow test capacity scores (WST) and duration of tube feeding.
  
  
  RESULTS
  The primary site distribution was as follows: 21 oropharynx, 8 larynx, 6 mucosectomy and 6 hypopharynx. T stages included 7 staged Tx, 21 T1-T2 tumours and 1 T3 tumour. Moderate-to-severe comorbidity was found in 45/51 patients. Mean PSS score was 83 (sd 27.54); mean WST score was 11.14 (sd 7.97). Most patients (73%) required tube feeding post-operatively, with mean tube feed duration of 18.08 days (sd 17.91); 76% resumed oral intake by 6 weeks. Pre-treatment swallow tests showed moderate negative correlation with tube feeding duration: PSS (rho 0-.430, P = .003); WST (rho 0-.503, P = 0.002).
  
  
  CONCLUSIONS
  The majority of TORS patients resume oral intake by 6 weeks. This study shows that impaired swallowing prior to surgery correlates with post-operative duration of tube feeding and strengthens the evidence for the utility of these measures in this clinical setting.
authors.affiliation: Newcastle University, Newcastle upon Tyne, UK.
authors.forename: S
authors.initials: S
authors.lastname: Owen
authors.affiliation: Department of Otolaryngology, Head-Neck Surgery, Colchester Hospital University NHS Foundation Trust, Essex, UK.
authors.forename: M
authors.initials: M
authors.lastname: Puvanendran
authors.affiliation: Department of Otolaryngology, Head-Neck Surgery, Freeman Hospital, Newcastle upon Tyne University Hospitals NHS Trust, Newcastle upon Tyne, UK.
authors.forename: D
authors.initials: D
authors.lastname: Meikle
authors.affiliation: Adult Nutrition and Dietetics Service, Freeman Hospital, Newcastle upon Tyne University Hospitals NHS Trust, Newcastle upon Tyne, UK.
authors.forename: I
authors.initials: I
authors.lastname: Bowe
authors.affiliation: Department of Otolaryngology, Head-Neck Surgery, Freeman Hospital, Newcastle upon Tyne University Hospitals NHS Trust, Newcastle upon Tyne, UK.
authors.forename: J
authors.initials: J
authors.lastname: O'Hara
authors.affiliation: Department of Otolaryngology, Head-Neck Surgery, Colchester Hospital University NHS Foundation Trust, Essex, UK.
authors.forename: J
authors.initials: J
authors.lastname: Patterson
authors.affiliation: Department of Otolaryngology, Head-Neck Surgery, Freeman Hospital, Newcastle upon Tyne University Hospitals NHS Trust, Newcastle upon Tyne, UK.|Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: V
authors.initials: V
authors.lastname: Paleri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000503:physiopathology*; D004185:Disability Evaluation; D004750:Enteral Nutrition; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011446:Prospective Studies; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome