Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
PLoS One. 2022 Jun 24;17(6):e0270509. doi: 10.1371/journal.pone.0270509. eCollection 2022.
Transoral surgery (TOS) has been widely used to treat laryngopharyngeal cancers. Although TOS is a minimally invasive procedure, postoperative complications, such as postoperative dysphagia, may occur, which can lead to a poor quality of life for patients undergoing TOS. This study aimed to investigate factors that may affect swallowing function in patients who underwent TOS for laryngopharyngeal cancers. Swallowing function of 84 patients who underwent endoscopic resection for oropharyngeal, hypopharyngeal, and supraglottic lesions was evaluated by the Functional Outcome Swallowing Scale, and predictors for postoperative dysphagia were identified. Multivariate analysis identified the following factors as independent predictors for postoperative dysphagia: Eastern Cooperative Oncology Group Performance Status (ECOG PS, p = 0.008), prior neck radiation therapy (p = 0.008), and operative time (p = 0.021). This study suggests that patients with poor ECOG PS or those who received prior neck radiation therapy should be fully assessed for preoperative swallowing function. In the future, we would like to clarify the criteria for preoperative swallowing evaluation to create a system that can identify patients suitable for TOS.
经口手术（TOS）已广泛用于治疗喉咽癌。尽管 TOS 是一种微创性手术，但术后可能会出现并发症，如吞咽困难，这可能导致接受 TOS 的患者生活质量下降。本研究旨在探讨可能影响接受 TOS 治疗的喉咽癌患者吞咽功能的因素。通过功能性吞咽量表评估 84 例接受经内镜切除口咽、下咽和喉上部病变的患者的吞咽功能，并确定术后吞咽困难的预测因素。多因素分析确定了以下因素是术后吞咽困难的独立预测因素：东部肿瘤协作组体能状态（ECOG PS，p=0.008）、既往颈部放疗（p=0.008）和手术时间（p=0.021）。本研究表明，ECOG PS 差或接受过颈部放疗的患者应充分评估术前吞咽功能。将来，我们希望阐明术前吞咽评估的标准，以建立一种能够识别适合 TOS 患者的系统。
