Prospective Evaluation of Swallowing Symptoms in Human Papillomavirus-Associated Oropharynx Cancer

Dysphagia. 2022 Feb;37(1):58-64. doi: 10.1007/s00455-021-10249-9. Epub 2021 Feb 4.

Abstract

To demonstrate that the lack of significant swallowing-related symptoms in patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma is attributable to smaller mucosal primaries. A validated dysphagia symptom questionnaire and eating assessment tool was prospectively provided to patients presenting with untreated human papillomavirus-associated oropharyngeal cancer at the University of Maryland from July 2017 to December 2018. A 10-item Eating Assessment Tool (EAT-10) was completed by each patient prior to intervention. All EAT-10 data were collected prospectively. Patient demographic and oncologic characteristics were also obtained. Seventy consecutive patients were enrolled and included in the study. This study cohort included 66 (94%) male patients. Sixty (86%) of patients were Caucasian. The mean EAT-10 score was 3.77 (95% CI 2.04, 5.50). Fifty-two (74.3%) patients presented with normal swallowing (EAT-10 scores less than 3). Spearman correlation indicated there was a significant positive association between tumor size and EAT-10 score (r(68) = 0.429, p < 0.005), with larger tumors associated with increased swallowing-related symptoms. The majority of patients presenting with HPV-associated oropharyngeal squamous cell carcinoma do not report any swallowing difficulties. Dysphagia-related symptoms are associated with large size tumors when they do occur.

Keywords: Dysphagia; EAT-10; Human papillomavirus; Oropharyngeal squamous cell carcinoma.

MeSH terms

  • Alphapapillomavirus*
  • Deglutition
  • Deglutition Disorders* / diagnosis
  • Deglutition Disorders* / etiology
  • Head and Neck Neoplasms*
  • Humans
  • Male
  • Oropharyngeal Neoplasms* / complications
  • Papillomaviridae