Severe postoperative dysphagia as an early predictor for decreased overall survival in patients with oral cancer. Issue 9 (September 2019)

• Record Type: Journal Article
• Authors: Klingelhöffer, Christoph; Obst, Annegret; Ettl, Tobias; Meier, Johannes; Müller, Steffen; Reichert, Torsten; Spanier, Gerrit
• Is Part Of: Journal of cranio-maxillofacial surgery. Volume 47:Issue 9(2019)
• Page Start: 1363
• Page End: 1369
• Publication Date: 2019-09
• Subjects: Dysphagia -- Swallowing -- Oral cancer -- Flap reconstruction -- Survival; Skull -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; Maxilla -- surgery -- Periodicals; Face -- surgery -- Periodicals; Skull -- surgery -- Periodicals; Oral Surgical Procedures -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Periodicals; Surgery, Oral -- Periodicals; Electronic journals; 617.514
• DOI: 10.1016/j.jcms.2019.06.011
• Languages: English
• ISSNs: 1010-5182

Abstract

Abstract: Objectives: The aim of this retrospective study was to analyze the early postoperative swallowing outcome in oral cancer patients considering risk factors and localization. Materials and methods: Four hundred patients with primary cases of oral cancer were included. Tumors' locations were categorized into four main groups (central, lateral, anterior and posterior). Swallowing function was evaluated at day 7 after surgery. Results: Ninety-eight percent (393/400) of the patients had a swallowing impairment including 41 (10.2%) patients who were unable to swallow. Strong risk factors with p values of 0.001 were tumor size, nodal stage, tracheotomy, insufficient dental status and reconstruction with a flap. The inability to swallow was increased at T1 und T2 patients, if they were reconstructed with a flap compared to patients who had a primary wound closure (p = 0.04). Decreased swallowing function was determined if the tumor was located central (OR = 1.8; p = 0.141) and additionally posterior (OR = 5.8; p = 0.110). Inability to swallow, even at that early point in time, (p = 0.001) was as significant as tumor size (p = 0.009) and nodal stage (p = 0.020), referring to overall survival. Conclusion: The impact of early dysphagia should not be underestimated. By considering swallowing impairment at the primary therapy patients can profit concerning survival and comorbidity.