OBJECTIVES: Dysphagia-related sequelae are common after head and neck cancer treatment. Our aims were 1) to document overall and site-specific dysphagia, stricture, and pneumonia rates in a Medicare population, 2) to calculate treatment-specific rates and adjusted odds of developing these complications, and 3) to track changes in rates between 1992 and 1999. METHODS: Head and neck cancer patients between 1992 and 1999 were identified in combined Surveillance Epidemiology and End Results (SEER) registry and Medicare databases. Multivariate analyses determined odds of dysphagia, stricture, and pneumonia based on modality. RESULTS: Of 8,002 patients, 40% of experienced dysphagia, 7% stricture, and 10% pneumonia within 3 years of treatment. In adjusted analyses, patients treated with chemoradiation had more than 2.5-times-greater odds of dysphagia than did those treated with surgery alone. Combined therapy was associated with increased odds of stricture (p<0.05). The odds of pneumonia were increased in patients treated with radiation with or without chemotherapy. Temporally, the dysphagia rates increased 10% during this period (p<0.05). CONCLUSIONS: Sequelae of head and neck cancer treatment are common and differ by treatment regimen. Those treated with chemoradiation had higher odds of experiencing dysphagia and pneumonia, whereas patients treated with any combined therapy more commonly experienced stricture. These sequelae represent major sources of morbidity and mortality in this population.
OBJECTIVES:Dysphagia-related sequelae are common after head and neck cancer treatment. Our aims were 1) to document overall and site-specific dysphagia, stricture, and pneumonia rates in a Medicare population, 2) to calculate treatment-specific rates and adjusted odds of developing these complications, and 3) to track changes in rates between 1992 and 1999. METHODS: Head and neck cancerpatients between 1992 and 1999 were identified in combined Surveillance Epidemiology and End Results (SEER) registry and Medicare databases. Multivariate analyses determined odds of dysphagia, stricture, and pneumonia based on modality. RESULTS: Of 8,002 patients, 40% of experienced dysphagia, 7% stricture, and 10% pneumonia within 3 years of treatment. In adjusted analyses, patients treated with chemoradiation had more than 2.5-times-greater odds of dysphagia than did those treated with surgery alone. Combined therapy was associated with increased odds of stricture (p<0.05). The odds of pneumonia were increased in patients treated with radiation with or without chemotherapy. Temporally, the dysphagia rates increased 10% during this period (p<0.05). CONCLUSIONS: Sequelae of head and neck cancer treatment are common and differ by treatment regimen. Those treated with chemoradiation had higher odds of experiencing dysphagia and pneumonia, whereas patients treated with any combined therapy more commonly experienced stricture. These sequelae represent major sources of morbidity and mortality in this population.
Authors: Larissa Sweeny; J Blake Golden; Hilliary N White; J Scott Magnuson; William R Carroll; Eben L Rosenthal Journal: Otolaryngol Head Neck Surg Date: 2011-12-13 Impact factor: 3.497
Authors: Katherine A Hutcheson; Zhannat Nurgalieva; Hui Zhao; Gary B Gunn; Sharon H Giordano; Mihir K Bhayani; Jan S Lewin; Carol M Lewis Journal: Head Neck Date: 2018-12-07 Impact factor: 3.147
Authors: David O Francis; Eric Hall; Jennifer H Dang; Gregory R Vlacich; James L Netterville; Michael F Vaezi Journal: Laryngoscope Date: 2014-10-24 Impact factor: 3.325
Authors: Alana Aylward; Sarah Abdelaziz; Jason P Hunt; Luke O Buchmann; Richard B Cannon; Shane Lloyd; Ying Hitchcock; Mia Hashibe; Marcus M Monroe Journal: Otolaryngol Head Neck Surg Date: 2019-06-11 Impact factor: 3.497
Authors: Katherine A Hutcheson; Mihir K Bhayani; Beth M Beadle; Kathryn A Gold; Eileen H Shinn; Stephen Y Lai; Jan Lewin Journal: JAMA Otolaryngol Head Neck Surg Date: 2013-11 Impact factor: 6.223
Authors: Caitriona B O'Neill; James P O'Neill; Coral L Atoria; Shrujal S Baxi; Martin C Henman; Ian Ganly; Elena B Elkin Journal: Laryngoscope Date: 2014-10-04 Impact factor: 3.325