Evidence map›Paper›PMID 30957243›Full record

ArticleThe Laryngoscope2020

Predictors of swallow function after transoral surgery for locally advanced oropharyngeal cancer.

Jennifer H Gross, Melanie Townsend, Helena Y Hong, Emily Miller, Dorina Kallogjeri, Joseph Zenga, Patrik Pipkorn, Ryan S Jackson, Bruce Haughey, Jason T Rich

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Laryngoscope, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Upfront Neck Dissection for Treatment Selection and Improvement in Quality of Life as a Novel Treatment Paradigm for Deintensification in HPV+ OPSCC.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024
    Trial
  3. Article
  4. Review
  5. Article
  6. Review
  7. Transoral Robotic Surgery and De-escalation of Cancer Treatment.Otolaryngologic clinics of North America · 2020
    Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jennifer H GrossDepartment of Otolaryngology, Washington University School of Medicine, Saint Louis, Missouri, U.S.A.ORCID 0000-0002-4241-4821
Melanie TownsendUniversity of Miami School of Medicine, Miami, Florida, U.S.A.
Helena Y HongDepartment of Otolaryngology, Washington University School of Medicine, Saint Louis, Missouri, U.S.A.
Emily MillerUniversity of Maryland Medical System, Baltimore, Maryland, U.S.A.
Dorina KallogjeriDepartment of Otolaryngology, Washington University School of Medicine, Saint Louis, Missouri, U.S.A.
Joseph ZengaMedical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.ORCID 0000-0003-1565-9628
Patrik PipkornDepartment of Otolaryngology, Washington University School of Medicine, Saint Louis, Missouri, U.S.A.
Ryan S JacksonDepartment of Otolaryngology, Washington University School of Medicine, Saint Louis, Missouri, U.S.A.
Bruce HaugheyFlorida ENT Surgical Specialists, Celebration, Florida, U.S.A.
Jason T RichDepartment of Otolaryngology, Washington University School of Medicine, Saint Louis, Missouri, U.S.A.

Funding

DEVELOPMENT OF CLINICIAN/RESEARCHERS IN ACADEMIC ENTT32DC000022 · NIDCD · WASHINGTON UNIVERSITY · PI PICCIRILLO, JAY F. · 1989 to 2022
$5.6M
NIDCD NIH HHS T32 DC000022
6 · The paper itself

Abstract

objectiveTransoral surgery (TOS) for oropharyngeal carcinoma (OPC) is steadily becoming more routine. Expected posttreatment swallow function is a critical consideration for preoperative counseling. The objective of this study was to identify predictors of swallow dysfunction following TOS for advanced tumor (T)-stage (T3-T4) OPC.

methodsA retrospective review from 1997 to 2016 at a single institution was performed. Eighty-two patients who underwent primary transoral resection of locally advanced OPCs with at least 1 year of postoperative follow-up were included. The primary outcome measure was swallow function, as measured by the Functional Outcomes Swallowing Scale (FOSS) at 1 year postoperatively. Operative reports were reviewed, and the extent of resection and type of reconstruction were documented. Conjunctive consolidation was then performed to incorporate multiple variables and their impact on swallow function into a clinically meaningful classification system.

resultsFifty-six patients (68%) had acceptable swallowing at 1 year. T4 tumor stage and receipt of adjuvant chemoradiation therapy (CRT) were strongly associated with poor swallowing but did not reach statistical significance. Only base of tongue (BOT) resection ≥50% (odds ratio [OR] 3.19, 95% confidence interval [CI] 1.21-8.43) and older age (OR 1.06, 95% CI 1.00-1.12) were significantly associated. Utilizing T-stage, adjuvant CRT, and BOT resection, a conjunctive consolidation was performed to develop a classification system for swallow dysfunction at 1 year.

conclusionThis study provides risk stratification for swallow function at 1 year following primary transoral resection of locally advanced OPCs. BOT resection ≥50%, especially when coupled with T4 tumor stage or adjuvant CRT, was associated with poor long-term swallow outcomes. LEVEL OF EVIDENCE: 3 Laryngoscope, 130:94-100, 2020.

Indexed as

AgedChemotherapy, AdjuvantDeglutition DisordersFemaleHumansMaleMiddle AgedMissouriNeoplasm StagingOropharyngeal NeoplasmsPostoperative ComplicationsRetrospective Studiesoropharynx cancerswallow functionTransoral surgery

Identifiers

PMID30957243
PMCPMC8932014

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.