Routine Use of Swallowing Outcome Measures Following Head and Neck Cancer in a Multidisciplinary Clinic Setting (2020)

Type of publication:
Journal article

Author(s):
*Annette C. Zuydam, Simon N. Rogers, Kate Grayson, *Clare F. Probert

Citation:
International Archives of Otorhinolaryngology, May 2020 [epub ahead of print]

Abstract:
Introduction: Chemoradiotherapy treatment for head and neck cancer (HNC) can have a major impact on swallowing function and health-related quality of life. The use of outcome measures in early detection of patients with swallowing problems provides the opportunity for targeting speech and language therapy (SLT) interventions to aid adaption and promote better clinical outcomes.
Objective: The purpose of the present study was to assess relationships between four outcomes measures over time, in a cohort of HNC patients, treated by (chemo-) radiotherapy.
Methods: Data were collected at 3 months and 12 months, on 49 consecutive patients with primary squamous cell cancer of the oropharynx, nasopharynx or hypopharynx stage T1–4, N0–2b, M0 disease.
Results: Out of 49 eligible patients, 45 completed assessment at 3 months and 20 at 12 months. The 3-month outcomes gave a strong indication of performance at 1 year. There were several strong correlations found between measures. The strongest was between the 3-month Performance Status Scale for Head and Neck Cancer (PSSHN) and the 12-month PSSHN (rs ¼ 0.761, n ¼ 17), the 12-month PSSHN and the 12-month
Functional Oral Intake Scale (FOIS) (rs ¼ 0.823, n ¼ 20), and the 12-month University of Washington Head and Neck Quality of Life (UWQoL) swallow and the 12-month Water Swallow Test (WST) capacity (rs ¼ 0.759, n ¼ 17).
Conclusion: The UW-QoL swallow item and WST are easy to incorporate into routine care and should be used as part of a standard assessment of swallow outcome. These measures can serve to help screen patients for dysfunction and focus allocation of resources for those who would benefit from more comprehensive assessment and intervention by SLT.

Link to full-text [Open access, no password required]

The diagnostic value of cytology in parotid Warthin’s tumors: international multicenter series (2020)

Type of publication:
Journal article

Author(s):
Borsetto, Daniele; Fussey, Jonathan M; Cazzador, Diego; Smith, Joel; Ciorba, Andrea; Pelucchi, Stefano; Donà, Sara; Boscolo-Rizzo, Paolo; Tomasoni, Michele; Lombardi, Davide; Nicolai, Piero; Zanoletti, Elisabetta; Colangeli, Roberta; Emanuelli, Enzo; *Osborne, Max S; *Ahsan, Syed F; Tofanelli, Margherita; Tirelli, Giancarlo; McNamara, Katherine; Liew, Leonard; *Harrison, Katherine; Fassina, Ambrogio; Sarcognato, Samantha; Sharma, Neil; Rao, Kanishka; Pracy, Paul; Nankivell, Paul

Citation:
Head & Neck; 2020; Vol 42(3) p. 522-529

Abstract:
INTRODUCTION Warthin’s tumor (WT) is a common benign salivary gland neoplasm with a negligible risk of malignant transformation. However, there is a risk of malignant tumors being misdiagnosed as WT on cytology and inappropriately managed conservatively.
METHODS Patients from nine centers in Italy and the United Kingdom undergoing parotid surgery for cytologically diagnosed WT were included in this multicenter retrospective series. Definitive histology was compared with preoperative cytological diagnoses. Surgical complications were recorded.
RESULTS A total of 496 tumors were identified. In 88.9%, the final histological diagnosis was WT. In 21 cases (4.2%) a malignant neoplasm was diagnosed, which had been incorrectly labeled as WT on cytology.
CONCLUSIONS The risk of undiagnosed malignancy should be balanced against surgical risks when considering the management of WT. Although nonsurgical management remains an appropriate option, there may be a rationale for serial clinical or radiological evaluation if surgical excision is not performed.

Link to full-text [NHS OpenAthens account required]

Human immunodeficiency disease in new diagnoses of head and neck squamous cell cancer: are we testing? (2019)

Type of publication:
Journal article

Author(s):
*McNamara K.J.; Saunders T.F.C.; *Ahsan F.; *Fernandez C.

Citation:
Journal of Laryngology and Otology; Vol. 133(12) p. 1038-1040

Abstract:
BACKGROUND: Human immunodeficiency virus infected patients have a three-fold increased risk of head and neck squamous cell carcinoma. The British HIV Association recommends human immunodeficiency virus testing in all new diagnoses of head and neck squamous cell carcinoma.
OBJECTIVE(S): This observational study aimed to examine the current routine practice of human immunodeficiency virus testing in patients with newly diagnosed head and neck squamous cell carcinoma, and to address the importance of this test in promoting the early diagnosis and treatment of human immunodeficiency virus.
METHOD(S): All head and neck cancer multidisciplinary teams in England were questioned on their protocol for human immunodeficiency virus testing in new diagnoses of head and neck squamous cell carcinoma.
RESULT(S): Only 1 out of 30 hospitals leading head and neck multidisciplinary teams (3.3 per cent) routinely offered human immunodeficiency virus testing in this high-risk patient group.
CONCLUSION(S): This observational study highlights that head and neck specialists are not aware of, and are consequently not complying with, routine human immunodeficiency virus testing as recommended by the British HIV Association guidelines.

Evaluation of patient and clinician reported outcomes in the routine clinical setting (2017)

Type of publication:
Poster presentation

Author(s):
*Zuydam AC, Rogers SN, Grayson, *McLaughlin K, *Probert, Voyce C

Citation:
British Association of Health and Neck Oncologists, BAHNO Annual Scientific Meeting, Royal College of Physicians, London, Friday 12th May 2017

Abstract:
Treatment for head and neck cancer can have an impact on both swallowing function ,and quality of life. It is important that any measures used have sufficient sensitivity to highlight issues .The aims of this study were to assess the relationship between swallowing assessments and to evaluate whether clinical swallowing measures can predict swallowing outcomes.

Methods
This was a prospective cohort study. Subjects had Primary Squamous cell cancer of the oropharynx, nasopharynx or hypopharynx Stage T1‐4, N0‐ 2b, M0 disease. Treatment was with Chemo‐radiotherapy/ radiotherapy ,including induction.The measures used were University of Washington Quality of Life Questionnaire , Performance Status Scale Head and Neck Cancer ( PSSHN) Functional Oral Intake Scale( FOIS ) and the Water Swallow Test ( WST).

Results

Data were collected on 38 patients. The 3m PSSHN was significantly correlated with both the 12m PSSHN (r = .761) and the 12m FOIS (r = .657 ).The 3m FOIS was correlated with the 3m PSSHN (r = .662 ).The 12m PSSHN was significantly correlated with the 12m FOIS (r = .823). The WST was also found to potentially have some predictive power.

Conclusions
A number of measures were found to have clinical significance, and could be valuable to collect in a clinic setting.. Identification of relevant issues early on can enable clinicians to provide patients with information about what they can expect ,and ensure intervention is timely.

Link to poster [no password required]