Swallowing Disorders, Survival and Functionality in Adults with Advanced Cancer Outside the Head and Neck and Upper Gastrointestinal Tract in Outpatient Palliative Care Setting: A Prospective Cohort Study.

In palliative care, there is still a lack of data regarding the relationship between survival, symptoms, and functionality. To investigate the relationship between functionality and both dysphagia-progression-free survival and overall survival in patients with advanced cancer. A prospective cohort conducted between March 2022 and August 2023. The study was conducted with patients with advanced cancer outside the head and neck and upper gastrointestinal tract, followed by an outpatient palliative care team. Sociodemographic, psychosocial, clinical, functional, and nutritional data were analyzed. A speech therapy evaluation was performed to classify swallowing disorders and the feeding route associated with swallowing ability. Two cohorts were analyzed according to functionality. 39 individuals were eligible, the majority being female. Lower functionality was a significant risk factor for mortality (p < 0.05), with a 4.31-fold increased risk of death. Minimal swallowing declines were associated with worse survival in patients with poorer functionality in univariable analysis (p = 0.01), but this association was not observed in multivariable analysis. Declining functionality was identified as a significant risk factor for mortality. Swallowing ability revealed a negative impact on survival in univariable analysis, however this association was not confirmed in the multivariable model. Likewise, dysphagia-progression-free survival was shorter among patients with poorer functionality, although this was not statistically significant in multivariable analysis. These findings underscore the need for further investigation.