Relationships among postoperative changes in swallowing function, nutritional status, and overall survival in patients with oral cancer.

PURPOSE: Dysphagia and malnutrition are frequent postoperative complications in oral cancer patients, increasing therapy-related risks and impacting survival. This study examined changes in swallowing function and nutritional status after surgery and their effects on overall survival.

METHODS

This retrospective cohort study at a medical center in Taiwan reviewed records of newly-diagnosed oral cancer patients who underwent surgery between January 2020 and December 2023. Clinical indicators including BMI, albumin, Functional Oral Intake Scale (FOIS), and Patient-Generated Subjective Global Assessment (PG-SGA) scores were collected at three time points: preoperatively (T1) and at 3 (T2) and 6 months (T3) postoperatively. Overall survival was calculated from the date of surgery (T0) to the fixed endpoint of August 31, 2024. Group-based trajectory modeling was used to identify temporal patterns, and Cox regression analysis was performed to examine survival-related factors.

RESULTS

A total of 120 patients were examined. During the study period, 42 patients died. The mean follow-up duration was 25.36 (SD = 13.42) months. The FOIS score changes were negatively associated with PG-SGA scores trajectories (χ2 = 7.37, p = .007) and positively associated with albumin trajectories (χ2 = 8.92, p = .003) and BMI trajectories (χ2 = 7.83, p = .020). Cox regression analysis showed that patients with Stage-IV cancer (HR = 47.85, 95 % CI: 2.02-1134.80), higher PG-SGA scores trajectories (HR = 2.77, 95 % CI: 1.19-6.46), and lower albumin levels trajectories (HR = 2.63, 95 % CI: 1.13-6.16) faced increased mortality risk.

CONCLUSIONS

Oral cancer patients showed poorer swallowing after surgery. Swallowing changes were linked to nutritional status, and postoperative nutrition was associated with survival, underscoring the need for monitoring and support.