Risk Factors for Postoperative Dysphagia in Patients with Oral Cavity and Oropharyngeal Cancer: A Systematic Review and Meta-analysis.

Abstract

This study was aimed at determining the risk factors for postoperative dysphagia, a common complication, in patients with oral cavity and oropharyngeal cancers. PubMed, Embase, Web of Science Core Collection, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang, SinoMed, and Weipu were searched up to July 9, 2023, for cross-sectional, cohort, and case-control studies on postoperative dysphagia-associated factors in patients with oral cavity and oropharyngeal cancers. Two researchers independently screened the articles. Twenty-one studies involving 3352 patients with oral cavity and oropharyngeal cancers were included. The relationship between postoperative dysphagia and 22 factors was analyzed. Nine of these were considered as definite or possible risk factors, including age of ≥ 60 years (odds ratio [OR] = 3.161, 95% confidence interval [CI]: 1.334-7.493), poor preoperative swallowing (OR = 2.618, 95% CI: 1.733-3.955), comorbidities (OR = 2.636, 95% CI: 1.556-4.467), stage T3 or T4 disease (OR = 2.864, 95% CI: 1.130-7.256), tumor in the oropharynx (OR = 1.890, 95% CI: 1.019-3.504), tongue base resection of ≥ 50% (OR = 6.092, 95% CI: 1.429-25.975), subtotal or total glossectomy (OR = 3.433, 95% CI: 1.407-8.376), extent of resection of the mouth floor (OR = 1.457, 95% CI: 1.089-1.949), and postoperative radiotherapy (OR = 2.247, 95% CI: 1.035-4.878). Nine risk factors for postoperative dysphagia in patients with oral cavity and oropharyngeal cancers were identified. Early identification of these risk factors can provide a basis for identifying and managing postoperative dysphagia in these patients.