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Impact of neck dissection on long‐term feeding tube dependence in patients with head and neck cancer treated with primary radiation or chemoradiation
Author(s) -
Lango Miriam N.,
Egleston Brian,
Ende Kevin,
Feigenberg Steven,
D'Ambrosio David J.,
Cohen Roger B.,
Ahmad Sidrah,
Nicolaou Nicos,
Ridge John A.
Publication year - 2010
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21188
Subject(s) - medicine , head and neck cancer , neck dissection , dysphagia , feeding tube , radiation therapy , surgery , retrospective cohort study , relative risk , chemoradiotherapy , dissection (medical) , head and neck squamous cell carcinoma , confidence interval , cancer
Background. The impact of posttreatment neck dissection on prolonged feeding tube dependence in patients with head and neck squamous cell cancer (HNSCC) treated with primary radiation or chemoradiation remains unknown. Methods. We conducted a retrospective cohort study using propensity score adjustment to investigate the effect of neck dissection on prolonged feeding tube dependence. Results. A review of 67 patients with node‐positive HNSCC (T1‐4N1‐3), treated with primary radiation or chemoradiation, with no evidence of tumor recurrence and follow‐up of at least 24 months, was performed. Following adjustment for covariates, the relative risk (RR) of feeding tube dependence at 18 months was significantly increased in patients treated with posttreatment neck dissection (RR 4.74, 95% confidence interval [CI] 2.07‐10.89). At 24 months, the relative risk of feeding tube dependence in the patients having undergone neck dissection increased further (RR 7.66, 95% CI 2.07‐10.89). Of patients with feeding tubes 2 years after completing treatment, 75% remained feeding tube dependent. Conclusion Neck dissection may contribute to chronic oropharyngeal dysphagia in HNSCC patients treated with primary radiation or chemoradiation. © 2009 Wiley Periodicals, Inc. Head Neck, 2010