Patient-Reported Swallowing Outcomes ≥5 Years After Neoadjuvant Chemotherapy and Transoral Robotic Surgery for HPV-positive Oropharyngeal Carcinoma.

Abstract

Objective: To evaluate long-term swallowing outcomes in patients with HPV-associated oropharyngeal squamous cell carcinoma (HPV + OPSCC) following neoadjuvant chemotherapy (NAC) and transoral robotic surgery (TORS) (NAC + S).

Study design: Retrospective cross-sectional study.

Setting: Single academic institution.

Methods: Patients completed the MD Anderson Dysphagia Inventory (MDADI) at various time points following the completion of treatment. Patients requiring adjuvant treatment, experiencing recurrent disease, or who did not complete an MDADI at least 5 years following treatment were excluded from the study. A linear regression model was explored to determine the relationship between time since treatment and MDADI score.

Results: A total of 21 patients treated with the NAC + S protocol were included. The average time between treatment and the most recent follow-up was 101.5 months. 1 patient had a composite MDADI score indicating poor function (<60), 3 indicating adequate function (≥60 to <80), and 17 indicating optimal function (≥80). There was no significant change in overall MDADI score (P = .469), global score (P = .163), emotional score (P = .528), and physical score (P = .903) over time. A small yet significant improvement in functional score of 1.06 points per year was seen over time (P = .0096).

Conclusion: Patients who were successfully treated with NAC + S maintain their favorable swallowing outcomes on long-term follow-up. A small improvement in functional MDADI sub-score may represent compensatory strategies or rehabilitation over time.