Swallowing Function Following Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharyngeal Carcinoma: A 2‐Year Follow‐up

Abstract

Objective To evaluate 2‐year follow‐up swallowing function in patients with human papillomavirus–related oropharyngeal squamous cell carcinoma (HPV+ OPSCC) who completed neoadjuvant chemotherapy and transoral robotic surgery (NAC+S) Study Design Retrospective analysis of patients with OPSCC treated with NAC+S between 2010 and 2021. Setting A single academic institution. Methods This is a cross‐sectional study of patient‐reported swallowing function, assessed with the MD Anderson Dysphagia Inventory (MDADI) at least 2 years after completion of treatment. The inclusion criteria are patients with HPV+ OPSCC who underwent NAC+S at least 2 years ago. Those requiring adjuvant radiation or chemoradiation or experiencing relapse were excluded from the study. Results Completed MDADIs were received from 37 patients at a median 3.8 years posttreatment (interquartile range, 2.0‐8.6 years). Of those, 94.6% (n = 35) were male and 81.1% (n = 30) were White. The median age at OPSCC diagnosis was 59.0 years (interquartile range, 41‐80 years). The most frequent primary subsite of OPSCC was the base of the tongue (n = 20, 54.1%), followed by the tonsils (n = 16, 43.2%). In addition, 75.7% (n = 28) had stage IVa disease (TNM seventh edition), and 29 (78.4%) had scores ≥80, classified as optimal function. When compared with patients who received bilateral neck dissection, patients who received unilateral neck dissection were associated with an age <65 years old ( P =. 036) and lower clinical TNM stage ( P =. 04), as well as higher composite, emotional, functional, and physical MDADI scores ( P =. 017,. 046,. 013, and. 05, respectively). Conclusion Patients with OPSCC who were treated with NAC+S achieved satisfactory long‐term swallowing outcomes. Unilateral neck dissection was significantly associated with higher MDADI scores in this patient cohort.