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Dysphagia after primary transoral robotic surgery with neck dissection vs nonsurgical therapy in patients with low- to intermediate-risk oropharyngeal cancer

JAMA Otolaryngology-Head & Neck Surgery Dec 07, 2019

Hutcheson KA, Warneke CL, Yao CMKL, et al. - In this cases series study involving 257 individuals (mean [SD] age, 59.54 [9.07] years; 222 [86.4%] male), researchers measured rates of acute dysphagia and recovery after transoral robotic surgery (TORS) and contrasted swallowing outcomes by primary treatment modality (TORS or radiotherapy). Data were obtained from individuals enlisted from March 1, 2015, to February 28, 2018, at a single academic institution who, according to the AJCC Staging Manual, 7th edition TNM classification, had low- to intermediate-risk human papillomavirus–related oropharyngeal squamous cell carcinoma possibly resectable by TORS. The authors discovered that moderate-severe acute dysphagia prevalence after TORS (per Dynamic Imaging Grade of Swallowing Toxicity grade ≥ 2) was 22.7%, with partial recovery that did not return to baseline by 3 to 6 months. Dysphagia profiles differed in the short term but not by 3 to 6 months of subacute recovery between patients with primary TORS and the groups receiving primary radiotherapy. Subacute swallowing outcomes were comparable in patients with low- to intermediate-risk oropharyngeal squamous cell carcinoma, irrespective of the primary treatment modality.
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