Faculty Collaboration Database

Aspiration, weight loss, and quality of life in head and neck cancer survivors. Arch Otolaryngol Head Neck Surg 2004 Sep;130(9):1100-3

Date

09/24/2004

Pubmed ID

15381598

DOI

10.1001/archotol.130.9.1100

Scopus ID

2-s2.0-4444239650 (requires institutional sign-in at Scopus site)   100 Citations

Abstract

OBJECTIVE: To determine associations between objective assessments (swallowing function and weight change) and subjective quality-of-life (QOL) measures.

DESIGN: Observational case series using clinical testing and questionnaires.

SETTING: University hospital-based tertiary clinical practice.

PATIENTS: Convenience sample of 5-year survivors of head and neck cancer (62 nonlaryngectomy survivors were studied).

INTERVENTIONS: Objective testing included examination, weight history, videofluoroscopic swallow studies (VFSS), and oropharyngeal swallowing efficiency (OPSE). Subjective testing included QOL questionnaires (University of Washington Quality-of-Life [UWQOL] Scale, Performance Status Scale for Head and Neck Cancer Patients [PSS-HN], Functional Assessment of Cancer Treatment-General [FACT-G] Scales, and Functional Assessment of Cancer Therapy-Head and Neck [FACT-H&N] Scale).

MAIN OUTCOME MEASURES: Aspiration (identified by VFSS), weight change, and QOL measures.

RESULTS: Aspiration was associated with the decreased QOL scores in chewing, swallowing, normalcy of diet, and additional concerns of the FACT-H&N Scale. No association was found between aspiration and willingness to eat in public, subjective understandability, or any of the FACT-G scales. Of the nonlaryngectomy survivors, 27 (44%) demonstrated some degree of aspiration during VFSS. Associations were found between aspiration, primary tumor T stage, weight change, and OPSE. Aspirators lost a mean of 10.0 kg from precancer treatment weight, while nonaspirators gained a mean of 2.3 kg (P<.001). Mean OPSE scores were 69 for nonaspirators and 53 for aspirators (P =.01).

CONCLUSIONS: Almost half of long-term nonlaryngectomy head and neck cancer survivors demonstrated at least some degree of aspiration. The presence of aspiration is associated with substantial weight loss, advanced initial tumor stage, diminished oropharyngeal swallowing efficiency, and lower scores on a variety of QOL scales.

Author List

Campbell BH, Spinelli K, Marbella AM, Myers KB, Kuhn JC, Layde PM

Author

Bruce H. Campbell MD Emeritus Professor in the Otolaryngology department at Medical College of Wisconsin

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

Cross-Sectional Studies
Deglutition Disorders
Female
Head and Neck Neoplasms
Humans
Male
Middle Aged
Quality of Life
Survivors
Weight Loss
Wisconsin