Dept. of Head & Neck Surgical Oncology, Homi Bhabha Cancer Hospital and Research Centre (A Unit of Tata Memorial Centre), Mullanpur/Sangrur, Punjab, India.
Dept. of Head & Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Parel, Mumbai 400012, Maharashtra, India.
Oral Oncol. 2022 Feb;125:105684. doi: 10.1016/j.oraloncology.2021.105684. Epub 2021 Dec 25.
The swallowing outcomes in patients undergoing glossectomy have been inconsistently reported in the literature owing to variable follow up times, different tools for assessment and lack of single institution large scale studies. The aim of our study was to assess the patterns of swallowing outcomes over time and identify factors affecting nasogastric tube dependency at 1-year post-surgery.
This was a retrospective study of treatment naïve patients with oral tongue carcinoma who underwent surgery and attended the speech and swallow clinic between January 2016 and December 2019 at our institute were included in the study. The findings of swallowing assessment by a speech language pathologist at three time points were recorded.
A total of 606 patients were found eligible for the study. The median age of the patients was 50 years with the 211 (34.8%) patients having T3/T4 disease. The swallowing outcomes in terms of tube dependence and the spectrum of diet tolerance seem to improve over time with an increasing number of patients switching over to a solid diet by 1 year. A higher defect class (HR = 24.43 [3.48-171.27]) and presence of co-morbidities (HR = 4.17 [1.59-10.92]) were associated with sustained feeding tube dependency status at 1 year. A nomogram was developed based on these findings.
The swallowing outcomes in terms of tube dependence and the spectrum of diet tolerance seem to improve over time. A higher defect class and presence of co-morbidities were associated with NGT dependency at 1 year.
由于随访时间不同、评估工具不同以及缺乏单一机构的大规模研究，行舌切除术患者的吞咽结果在文献中报道不一致。我们研究的目的是评估随时间推移的吞咽结果模式，并确定 1 年后影响鼻胃管依赖性的因素。
这是一项回顾性研究，纳入了 2016 年 1 月至 2019 年 12 月期间在我院行手术且在言语和吞咽诊所就诊的初治口腔舌癌患者。记录了言语病理学家在三个时间点的吞咽评估结果。
共发现 606 例患者符合研究条件。患者的中位年龄为 50 岁，211 例（34.8%）患者患有 T3/T4 期疾病。在 1 年内，依赖鼻胃管的吞咽结果和饮食耐受性的范围似乎随着时间的推移而改善，越来越多的患者转为固体饮食。较高的缺陷分级（HR=24.43[3.48-171.27]）和合并症存在（HR=4.17[1.59-10.92]）与 1 年内持续喂养管依赖性相关。根据这些发现开发了一个列线图。
依赖鼻胃管的吞咽结果和饮食耐受性的范围似乎随时间推移而改善。较高的缺陷分级和合并症存在与 1 年内依赖 NGT 相关。
