Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Optimized decision support for selection of transoral robotic surgery or (chemo)radiation therapy based on posttreatment swallowing toxicity
Cancer Medicine, Volume 12, No. 4, Year 2023
Notification
URL copied to clipboard!
Description
Background: A primary goal in transoral robotic surgery (TORS) for oropharyngeal squamous cell cancer (OPSCC) survivors is to optimize swallowing function. However, the uncertainty in the outcomes of TORS including postoperative residual positive margin (PM) and extranodal extension (ENE), may necessitate adjuvant therapy, which may cause significant swallowing toxicity to survivors. Methods: A secondary analysis was performed on a prospective registry data with low- to intermediate-risk human papillomavirus–related OPSCC possibly resectable by TORS. Decision trees were developed to model the uncertainties in TORS compared with definitive radiation therapy (RT) and chemoradiation therapy (CRT). Swallowing toxicities were measured by Dynamic Imaging Grade of Swallowing Toxicity (DIGEST), MD Anderson Dysphagia Inventory (MDADI), and the MD Anderson Symptom Inventory–Head and Neck (MDASI-HN) instruments. The likelihoods of PM/ENE were varied to determine the thresholds within which each therapy remains optimal. Results: Compared with RT, TORS resulted in inferior swallowing function for moderate likelihoods of PM/ENE (>60% in short term for all instruments, >75% in long term for DIGEST and MDASI) leaving RT as the optimal treatment. Compared with CRT, TORS remained the optimal therapy based on MDADI and MDASI but showed inferior swallowing outcomes based on DIGEST for moderate-to-high likelihoods of PM/ENE (>75% for short-term and >40% for long-term outcomes). Conclusion: In the absence of reliable estimation of postoperative PM/ENE concurrent with significant postoperative PM, the overall toxicity level in OPSCC patients undergoing TORS with adjuvant therapy may become more severe compared with patients receiving nonsurgical treatments thus advocating definitive (C)RT protocols. © 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Authors & Co-Authors
Barbon, Carly E.A.
United States, Houston
The University of Texas Md Anderson Cancer Center
Mohamed, Abdallah Sherif Radwan
United States, Houston
The University of Texas Md Anderson Cancer Center
United States, Houston
University of Texas Graduate School of Biomedical Sciences at Houston
van Dijk, Lisanne Vania
United States, Houston
The University of Texas Md Anderson Cancer Center
Netherlands, Groningen
Universitair Medisch Centrum Groningen
Moreno, Amy C.
United States, Houston
The University of Texas Md Anderson Cancer Center
Gross, Neil D.
United States, Houston
The University of Texas Md Anderson Cancer Center
Goepfert, Ryan P.
United States, Houston
The University of Texas Md Anderson Cancer Center
Lai, Stephen Y.
United States, Houston
The University of Texas Md Anderson Cancer Center
United States, Houston
University of Texas Graduate School of Biomedical Sciences at Houston
Hutcheson, Katherine A.
United States, Houston
The University of Texas Md Anderson Cancer Center
United States, Houston
University of Texas Graduate School of Biomedical Sciences at Houston
Schaefer, Andrew J.
Unknown Affiliation
Fuller, Clifton David
United States, Houston
The University of Texas Md Anderson Cancer Center
United States, Houston
University of Texas Graduate School of Biomedical Sciences at Houston
Statistics
Authors: 10
Affiliations: 3
Identifiers
Doi:
10.1002/cam4.5253
ISSN:
20457634
Research Areas
Cancer
Health System And Policy
Study Design
Cohort Study