Skip to main content
Erschienen in: Dysphagia 1/2023

02.07.2022 | Original Article

Risk Factors for Feeding Tube Dependency in Patients Undergoing Function Preservation Surgery for Advanced-Stage Laryngohypopharyngeal Cancer

verfasst von: Manal Bin-Manie, Yeonjoo Choi, Jong-Lyel Roh, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim

Erschienen in: Dysphagia | Ausgabe 1/2023

Einloggen, um Zugang zu erhalten

Abstract

Dysphagia and feeding tube dependency commonly occur in patients with laryngeal or hypopharyngeal cancer (LHC) during and after treatment, often leading to poor functional outcomes. Therefore, we examined the factors related to feeding tube dependency among advanced-stage LHC patients undergoing curative surgery. This study included 69 consecutive patients who underwent conservative surgery for previously untreated, advanced-stage LHC (squamous cell carcinoma) between 2006 and 2016. Persistent feeding tube dependency was defined as 1 year or more after treatment completion. Binary logistic regression analysis was used to determine the factors associated with reactive prolonged and persistent feeding tube dependency. Cox proportional hazard regression analysis was used to determine the association between feeding tube dependency and survival. None of the study patients had a prophylactic feeding tube, but 15 (21.7%) patients had reactive feeding tube placement for 3 months or more. A total of 9 (13.0%) patients had persistent feeding tube dependency. Univariate analysis showed that age, tracheostomy, and common terminology criteria for adverse events (CTCAE) ≥ 3 were significantly associated with reactive prolonged and persistent feeding tube dependency (all P < 0.05). In the multivariate analysis, advanced age and CTCAE ≥ 3 remained the independent factors of reactive prolonged and persistent feeding tube dependency (all P < 0.05). Feeding tube dependency was not associated with overall survival or disease-free survival (P > 0.1). Feeding tube dependency might be related to clinical factors, such as age and severe adverse events, in the patients undergoing function-preserving surgery for advanced-stage LHC.
Literatur
1.
Zurück zum Zitat Jang JY, Kim EH, Cho J, et al. Comparison of oncological and functional outcomes between initial surgical versus non-surgical treatments for hypopharyngeal cancer. Ann Surg Oncol. 2016;23:2054–61. Jang JY, Kim EH, Cho J, et al. Comparison of oncological and functional outcomes between initial surgical versus non-surgical treatments for hypopharyngeal cancer. Ann Surg Oncol. 2016;23:2054–61.
2.
Zurück zum Zitat Qian W, Zhu G, Wang Y, et al. Multi-modality management for loco-regionally advanced laryngeal and hypopharyngeal cancer: balancing the benefit of efficacy and functional preservation. Med Oncol. 2014;31:178. Qian W, Zhu G, Wang Y, et al. Multi-modality management for loco-regionally advanced laryngeal and hypopharyngeal cancer: balancing the benefit of efficacy and functional preservation. Med Oncol. 2014;31:178.
3.
Zurück zum Zitat Ahn SH, Hong HJ, Kwon SY, et al. Guidelines for the surgical management of laryngeal cancer: Korean society of thyroid-head and neck surgery. Clin Exp Otorhinolaryngol. 2017;10:1–43. Ahn SH, Hong HJ, Kwon SY, et al. Guidelines for the surgical management of laryngeal cancer: Korean society of thyroid-head and neck surgery. Clin Exp Otorhinolaryngol. 2017;10:1–43.
4.
Zurück zum Zitat Kim BH, Park SJ, Jeong WJ, Ahn SH. Comparison of treatment outcomes for T3 glottic squamous cell carcinoma: a meta-analysis. Clin Exp Otorhinolaryngol. 2018;11:1–8. Kim BH, Park SJ, Jeong WJ, Ahn SH. Comparison of treatment outcomes for T3 glottic squamous cell carcinoma: a meta-analysis. Clin Exp Otorhinolaryngol. 2018;11:1–8.
5.
Zurück zum Zitat Batth SS, Caudell JJ, Chen AM. Practical considerations in reducing swallowing dysfunction following concurrent chemoradiotherapy with intensity-modulated radiotherapy for head and neck cancer. Head Neck. 2014;36:291–8. Batth SS, Caudell JJ, Chen AM. Practical considerations in reducing swallowing dysfunction following concurrent chemoradiotherapy with intensity-modulated radiotherapy for head and neck cancer. Head Neck. 2014;36:291–8.
6.
Zurück zum Zitat Wang X, Hu C, Eisbruch A. Organ-sparing radiation therapy for head and neck cancer. Nat Rev Clin Oncol. 2011;8:639–48. Wang X, Hu C, Eisbruch A. Organ-sparing radiation therapy for head and neck cancer. Nat Rev Clin Oncol. 2011;8:639–48.
7.
Zurück zum Zitat Rinkel RN, Verdonck-de Leeuw IM, Doornaert P, et al. Prevalence of swallowing and speech problems in daily life after chemoradiation for head and neck cancer based on cut-off scores of the patient-reported outcome measures SWAL-QOL and SHI. Eur Arch Otorhinolaryngol. 2016;273:1849–55. Rinkel RN, Verdonck-de Leeuw IM, Doornaert P, et al. Prevalence of swallowing and speech problems in daily life after chemoradiation for head and neck cancer based on cut-off scores of the patient-reported outcome measures SWAL-QOL and SHI. Eur Arch Otorhinolaryngol. 2016;273:1849–55.
8.
Zurück zum Zitat Bussu F, Paludetti G, Almadori G, et al. Comparison of total laryngectomy with surgical (cricohyoidopexy) and nonsurgical organ-preservation modalities in advanced laryngeal squamous cell carcinomas: a multicenter retrospective analysis. Head Neck. 2013;35:554–61. Bussu F, Paludetti G, Almadori G, et al. Comparison of total laryngectomy with surgical (cricohyoidopexy) and nonsurgical organ-preservation modalities in advanced laryngeal squamous cell carcinomas: a multicenter retrospective analysis. Head Neck. 2013;35:554–61.
9.
Zurück zum Zitat Bussu F, Galli J, Valenza V, et al. Evaluation of swallowing function after supracricoid laryngectomy as a primary or salvage procedure. Dysphagia. 2015;30:686–94. Bussu F, Galli J, Valenza V, et al. Evaluation of swallowing function after supracricoid laryngectomy as a primary or salvage procedure. Dysphagia. 2015;30:686–94.
10.
Zurück zum Zitat Bussu F, Almadori G, De Corso E, et al. Endoscopic horizontal partial laryngectomy by CO(2) laser in the management of supraglottic squamous cell carcinoma. Head Neck. 2009;31:1196–206. Bussu F, Almadori G, De Corso E, et al. Endoscopic horizontal partial laryngectomy by CO(2) laser in the management of supraglottic squamous cell carcinoma. Head Neck. 2009;31:1196–206.
11.
Zurück zum Zitat Bozec A, Benezery K, Chamorey E, et al. Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program. Eur Arch Otorhinolaryngol. 2016;273:2681–7. Bozec A, Benezery K, Chamorey E, et al. Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program. Eur Arch Otorhinolaryngol. 2016;273:2681–7.
12.
Zurück zum Zitat Mangar S, Slevin N, Mais K, Sykes A. Evaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: a retrospective review. Radiother Oncol. 2006;78:152–8. Mangar S, Slevin N, Mais K, Sykes A. Evaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: a retrospective review. Radiother Oncol. 2006;78:152–8.
13.
Zurück zum Zitat Lewis SL, Brody R, Touger-Decker R, et al. Feeding tube use in patients with head and neck cancer. Head Neck. 2014;36:1789–95. Lewis SL, Brody R, Touger-Decker R, et al. Feeding tube use in patients with head and neck cancer. Head Neck. 2014;36:1789–95.
14.
Zurück zum Zitat Cheng SS, Terrell JE, Bradford CR, et al. Variables associated with feeding tube placement in head and neck cancer. Arch Otolaryngol Head Neck Surg. 2006;132:655–61. Cheng SS, Terrell JE, Bradford CR, et al. Variables associated with feeding tube placement in head and neck cancer. Arch Otolaryngol Head Neck Surg. 2006;132:655–61.
15.
Zurück zum Zitat Roberge C, Tran M, Massoud C, et al. Quality of life and home enteral tube feeding: a French prospective study in patients with head and neck or oesophageal cancer. Br J Cancer. 2000;82:263–9. Roberge C, Tran M, Massoud C, et al. Quality of life and home enteral tube feeding: a French prospective study in patients with head and neck or oesophageal cancer. Br J Cancer. 2000;82:263–9.
16.
Zurück zum Zitat Schweinfurth JM, Boger GN, Feustel PJ. Preoperative risk assessment for gastrostomy tube placement in head and neck cancer patients. Head Neck. 2001;23:376–82. Schweinfurth JM, Boger GN, Feustel PJ. Preoperative risk assessment for gastrostomy tube placement in head and neck cancer patients. Head Neck. 2001;23:376–82.
17.
Zurück zum Zitat Al-Othman MO, Amdur RJ, Morris CG, et al. Does feeding tube placement predict for long-term swallowing disability after radiotherapy for head and neck cancer? Head Neck. 2003;25:741–7. Al-Othman MO, Amdur RJ, Morris CG, et al. Does feeding tube placement predict for long-term swallowing disability after radiotherapy for head and neck cancer? Head Neck. 2003;25:741–7.
18.
Zurück zum Zitat Karsten RT, Stuiver MM, van der Molen L, et al. From reactive to proactive tube feeding during chemoradiotherapy for head and neck cancer: a clinical prediction model-based approach. Oral Oncol. 2019;88:172–9. Karsten RT, Stuiver MM, van der Molen L, et al. From reactive to proactive tube feeding during chemoradiotherapy for head and neck cancer: a clinical prediction model-based approach. Oral Oncol. 2019;88:172–9.
19.
Zurück zum Zitat Wopken K, Bijl HP, Langendijk JA. Prognostic factors for tube feeding dependence after curative (chemo-) radiation in head and neck cancer: a systematic review of literature. Radiother Oncol. 2018;126:56–67. Wopken K, Bijl HP, Langendijk JA. Prognostic factors for tube feeding dependence after curative (chemo-) radiation in head and neck cancer: a systematic review of literature. Radiother Oncol. 2018;126:56–67.
20.
Zurück zum Zitat Forastiere AA, Ismaila N, Lewin JS, et al. Use of Larynx-preservation strategies in the treatment of laryngeal cancer: American society of clinical oncology clinical practice guideline update. J Clin Oncol. 2018;36:1143–69. Forastiere AA, Ismaila N, Lewin JS, et al. Use of Larynx-preservation strategies in the treatment of laryngeal cancer: American society of clinical oncology clinical practice guideline update. J Clin Oncol. 2018;36:1143–69.
21.
Zurück zum Zitat Joo YH, Cho JK, Koo BS, et al. Guidelines for the surgical management of oral cancer: Korean society of thyroid-head and neck surgery. Clin Exp Otorhinolaryngol. 2019;12:107–44. Joo YH, Cho JK, Koo BS, et al. Guidelines for the surgical management of oral cancer: Korean society of thyroid-head and neck surgery. Clin Exp Otorhinolaryngol. 2019;12:107–44.
23.
Zurück zum Zitat Bernal-Sprekelsen M, Vilaseca-González I, Blanch-Alejandro JL. Predictive values for aspiration after endoscopic laser resections of malignant tumors of the hypopharynx and larynx. Head Neck. 2004;26:103–10. Bernal-Sprekelsen M, Vilaseca-González I, Blanch-Alejandro JL. Predictive values for aspiration after endoscopic laser resections of malignant tumors of the hypopharynx and larynx. Head Neck. 2004;26:103–10.
24.
Zurück zum Zitat Weiss BG, Ihler F, Wolff HA, et al. Transoral laser microsurgery for treatment for hypopharyngeal cancer in 211 patients. Head Neck. 2017;39:1631–8. Weiss BG, Ihler F, Wolff HA, et al. Transoral laser microsurgery for treatment for hypopharyngeal cancer in 211 patients. Head Neck. 2017;39:1631–8.
25.
Zurück zum Zitat Lips M, Speyer R, Zumach A, et al. Supracricoid laryngectomy and dysphagia: a systematic literature review. Laryngoscope. 2015;125:2143–56. Lips M, Speyer R, Zumach A, et al. Supracricoid laryngectomy and dysphagia: a systematic literature review. Laryngoscope. 2015;125:2143–56.
26.
Zurück zum Zitat Mahalingam S, Srinivasan R, Spielmann P. Quality-of-life and functional outcomes following pharyngolaryngectomy: a systematic review of literature. Clin Otolaryngol. 2016;41:25–43. Mahalingam S, Srinivasan R, Spielmann P. Quality-of-life and functional outcomes following pharyngolaryngectomy: a systematic review of literature. Clin Otolaryngol. 2016;41:25–43.
27.
Zurück zum Zitat Murphy BA, Gilbert J, Ridner SH. Systemic and global toxicities of head and neck treatment. Expert Rev Anticancer Ther. 2007;7:1043–53. Murphy BA, Gilbert J, Ridner SH. Systemic and global toxicities of head and neck treatment. Expert Rev Anticancer Ther. 2007;7:1043–53.
28.
Zurück zum Zitat Wopken K, Bijl HP, van der Schaaf A, et al. Development of a multivariable normal tissue complication probability (NTCP) model for tube feeding dependence after curative radiotherapy/chemo-radiotherapy in head and neck cancer. Radiother Oncol. 2014;113:95–101. Wopken K, Bijl HP, van der Schaaf A, et al. Development of a multivariable normal tissue complication probability (NTCP) model for tube feeding dependence after curative radiotherapy/chemo-radiotherapy in head and neck cancer. Radiother Oncol. 2014;113:95–101.
29.
Zurück zum Zitat Machtay M, Moughan J, Farach A, et al. Hypopharyngeal dose is associated with severe late toxicity in locally advanced head-and-neck cancer: an RTOG analysis. Int J Radiat Oncol Biol Phys. 2012;84:983–9. Machtay M, Moughan J, Farach A, et al. Hypopharyngeal dose is associated with severe late toxicity in locally advanced head-and-neck cancer: an RTOG analysis. Int J Radiat Oncol Biol Phys. 2012;84:983–9.
30.
Zurück zum Zitat Corry J, Poon W, McPhee N, et al. Prospective study of percutaneous endoscopic gastrostomy tubes versus nasogastric tubes for enteral feeding in patients with head and neck cancer undergoing (chemo)radiation. Head Neck. 2009;31:867–76. Corry J, Poon W, McPhee N, et al. Prospective study of percutaneous endoscopic gastrostomy tubes versus nasogastric tubes for enteral feeding in patients with head and neck cancer undergoing (chemo)radiation. Head Neck. 2009;31:867–76.
31.
Zurück zum Zitat Ronis DL, Duffy SA, Fowler KE, et al. Changes in quality of life over 1 year in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 2008;134:241–8. Ronis DL, Duffy SA, Fowler KE, et al. Changes in quality of life over 1 year in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 2008;134:241–8.
32.
Zurück zum Zitat Paleri V, Roe JW, Strojan P, et al. Strategies to reduce long-term postchemoradiation dysphagia in patients with head and neck cancer: an evidence-based review. Head Neck. 2014;36:431–43. Paleri V, Roe JW, Strojan P, et al. Strategies to reduce long-term postchemoradiation dysphagia in patients with head and neck cancer: an evidence-based review. Head Neck. 2014;36:431–43.
33.
Zurück zum Zitat Tsou YA, Lin MH, Hua CH, et al. Comparison of pharyngeal stenosis between hypopharyngeal patients undergoing primary versus salvage laryngopharyngectomy. Otolaryngol Head Neck Surg. 2010;143:538–43. Tsou YA, Lin MH, Hua CH, et al. Comparison of pharyngeal stenosis between hypopharyngeal patients undergoing primary versus salvage laryngopharyngectomy. Otolaryngol Head Neck Surg. 2010;143:538–43.
34.
Zurück zum Zitat King SN, Dunlap NE, Tennant PA, Pitts T. Pathophysiology of radiation-induced dysphagia in head and neck cancer. Dysphagia. 2016;31:339–51. King SN, Dunlap NE, Tennant PA, Pitts T. Pathophysiology of radiation-induced dysphagia in head and neck cancer. Dysphagia. 2016;31:339–51.
35.
Zurück zum Zitat Lefebvre JL, Ang KK. Larynx preservation clinical trial design: key issues and recommendations–a consensus panel summary. Head Neck. 2009;31:429–41. Lefebvre JL, Ang KK. Larynx preservation clinical trial design: key issues and recommendations–a consensus panel summary. Head Neck. 2009;31:429–41.
36.
Zurück zum Zitat Brown T, Banks M, Hughes BGM, et al. Impact of early prophylactic feeding on long term tube dependency outcomes in patients with head and neck cancer. Oral Oncol. 2017;72:17–25. Brown T, Banks M, Hughes BGM, et al. Impact of early prophylactic feeding on long term tube dependency outcomes in patients with head and neck cancer. Oral Oncol. 2017;72:17–25.
Metadaten
Titel
Risk Factors for Feeding Tube Dependency in Patients Undergoing Function Preservation Surgery for Advanced-Stage Laryngohypopharyngeal Cancer
verfasst von
Manal Bin-Manie
Yeonjoo Choi
Jong-Lyel Roh
Seung-Ho Choi
Soon Yuhl Nam
Sang Yoon Kim
Publikationsdatum
02.07.2022
Verlag
Springer US
Erschienen in
Dysphagia / Ausgabe 1/2023
Print ISSN: 0179-051X
Elektronische ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-022-10488-4

Weitere Artikel der Ausgabe 1/2023

Dysphagia 1/2023 Zur Ausgabe

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.