[Pretreatment dysphagia in patients with advanced head and neck cancer]

Abstract

Objective: To define swallowing dysfunctions in head and neck cancer patients with respect to tumor site.

Patients and methods: A consecutive cohort of 52 patients with stage III-IV head and neck cancer without prior tracheotomy or treatment were studied according to tumor site: oral cavity (n = 8), oropharynx (n = 8), hypopharynx (n = 13) and larynx (23). All patients underwent nasoendoscopy prior to treatment. Swallowing function (dysphagia, aspiration and Swallowing Performance Status Seale score) was analyzed with reference to tumor localization using chi 2 and Fisher exact tests.

Results: Laryngeal and hypopharyngeal neoplasms neoplasms showed the most severe pre-treatment swallowing dysfunction (27% pre-treatment vs. 11% post-treatment), and oral and oropharyngeal neoplasms showed the most severe post-treatment swallowing dysfunction (6% pretreatment vs. 68% post-treatment). Aspiration and tumor localization revealed not statistically significant differences between groups. Pre-treatment dysphagia did not correlate with post-treatment dysphagia.

Conclusions: Laryngeal and hypopharyngeal neoplasms showed severe pre-treatment swallowing dysfunctional and oral and oropharyngeal neoplasms showed severe post-treatment swallowing dysfunction.