Faculty Collaboration Database

Prediction of Speech, Swallowing, and Quality of Life in Oral Cavity Cancer Patients: A Pilot Study. Laryngoscope 2021 Nov;131(11):2497-2504

Date

04/22/2021

Pubmed ID

33881173

DOI

10.1002/lary.29573

Scopus ID

2-s2.0-85104763710 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

OBJECTIVES/HYPOTHESIS: To investigate the impact of specific treatment-related variables on functional and quality of life outcomes in oral cavity cancer (OCC) patients.

STUDY DESIGN: Retrospective Cohort.

METHODS: Patients with primary OCC at least 6 months after resection and adjuvant therapy were included. Patients completed surveys including the Speech Handicap Index (SHI), M.D. Anderson Dysphagia Inventory (MDADI), and Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN). Performance Status Scale (PSS) and tongue mobility scale were completed to allow provider-rated assessment of speech and tongue mobility, respectively. Additional details regarding treatment were also collected. These data were used to generate a predictive model using linear regression.

RESULTS: Fifty-three patients with oral tongue and/or floor of mouth (FOM) resection were included in our study. In multivariable analysis, greater postoperative tongue range of motion (ROM) and time since treatment improved SHI. Flap reconstruction and greater postoperative tongue ROM increased MDADI and PSS (eating and speech). A larger volume of resected tissue was inversely correlated with PSS (diet and speech). Tumor site was an important predictor of PSS (all sections). There were no statistically significant predictors of FACT-HN.

CONCLUSIONS: In this pilot study, we propose a battery of tools to assess function in OCC patients treated with surgery. Using the battery of tools we propose, our results show that a surgical endpoint that preserves tongue mobility and employs flap reconstruction resulted in better outcomes, whereas those with greater volume of tissue resected and FOM involvement resulted in poorer outcomes. Larger prospective studies are needed to validate our findings.

LEVEL OF EVIDENCE: 3 Laryngoscope, 131:2497-2504, 2021.

Author List

Bulbul MG, Wu M, Lin D, Emerick K, Deschler D, Richmon J, Goldsmith T, Zenga J, Puram SV, Varvares MA

Author

Joseph Zenga MD Assistant Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Chemoradiotherapy, Adjuvant
Deglutition
Deglutition Disorders
Female
Humans
Male
Middle Aged
Mouth Neoplasms
Oral Surgical Procedures
Pilot Projects
Prognosis
Prospective Studies
Quality of Life
Retrospective Studies
Risk Assessment
Speech
Speech Disorders
Young Adult