{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:16:39Z","timestamp":1791465399061,"version":"4.3.4"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:sec id=\"ab-ooi230029-4\"><jats:title>Importance<\/jats:title><jats:p>Oncologic outcomes are similar for patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with primary surgery or radiotherapy. However, comparative differences in long-term patient-reported outcomes (PROs) between modalities are less well established.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230029-5\"><jats:title>Objective<\/jats:title><jats:p>To determine the association between primary surgery or radiotherapy and long-term PROs.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230029-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cross-sectional study used the Texas Cancer Registry to identify survivors of OPSCC treated definitively with primary radiotherapy or surgery between January 1, 2006, and December 31, 2016. Patients were surveyed in October 2020 and April 2021.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230029-7\"><jats:title>Exposures<\/jats:title><jats:p>Primary radiotherapy and surgery for OPSCC.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230029-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Patients completed a questionnaire that included demographic and treatment information, the MD Anderson Symptom Inventory\u2013Head and Neck (MDASI-HN) module, the Neck Dissection Impairment Index (NDII), and the Effectiveness of Auditory Rehabilitation (EAR) scale. Multivariable linear regression models were performed to evaluate the association of treatment (surgery vs radiotherapy) with PROs while controlling for additional variables.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230029-9\"><jats:title>Results<\/jats:title><jats:p>Questionnaires were mailed to 1600 survivors of OPSCC identified from the Texas Cancer Registry, with 400 responding (25% response rate), of whom 183 (46.2%) were 8 to 15 years from their initial diagnosis. The final analysis included 396 patients (aged \u226457 years, 190 [48.0%]; aged &amp;amp;gt;57 years, 206 [52.0%]; female, 72 [18.2%]; male, 324 [81.8%]). After multivariable adjustment, no significant differences were found between surgery and radiotherapy outcomes as measured by the MDASI-HN (\u03b2, \u22120.1; 95% CI, \u22120.7 to 0.6), NDII (\u03b2, \u22121.7; 95% CI, \u22126.7 to 3.4), and EAR (\u03b2, \u22120.9; 95% CI \u22127.7 to 5.8). In contrast, less education, lower household income, and feeding tube use were associated with significantly worse MDASI-HN, NDII, and EAR scores, while concurrent chemotherapy with radiotherapy was associated with worse MDASI-HN and EAR scores.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230029-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This population-based cohort study found no associations between long-term PROs and primary radiotherapy or surgery for OPSCC. Lower socioeconomic status, feeding tube use, and concurrent chemotherapy were associated with worse long-term PROs. Further efforts should focus on the mechanism, prevention, and rehabilitation of these long-term treatment toxicities. The long-term outcomes of concurrent chemotherapy should be validated and may inform treatment decision making.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2023.1323","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T15:33:21Z","timestamp":1688052801000},"page":"697","source":"Crossref","is-referenced-by-count":10,"title":["Long-term Patient-Reported Outcomes in a Population-Based Cohort Following Radiotherapy vs Surgery for Oropharyngeal Cancer"],"prefix":"10.1001","volume":"149","author":[{"given":"Michael J.","family":"Dohopolski","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Diao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Hutcheson","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil S.","family":"Akhave","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan P.","family":"Goepfert","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiguo","family":"He","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiudong Jennifer","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan K.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Behavioral Science, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baran D.","family":"Sumer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Sher","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"key":"ooi230029r2","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.ctro.2017.12.002","article-title":"Surgery vs. primary radiotherapy in early-stage oropharyngeal cancer.","volume":"9","author":"Pedro","year":"2017","journal-title":"Clin Transl Radiat Oncol"},{"issue":"3","key":"ooi230029r3","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1038\/sj.bjc.6602696","article-title":"Surgery and adjuvant radiotherapy vs concurrent chemoradiotherapy in stage III\/IV nonmetastatic squamous cell head and neck cancer: a randomised comparison.","volume":"93","author":"Soo","year":"2005","journal-title":"Br J Cancer"},{"issue":"8","key":"ooi230029r4","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1200\/JCO.21.01961","article-title":"Randomized trial of radiotherapy versus transoral robotic surgery for oropharyngeal squamous cell carcinoma: long-term results of the ORATOR trial.","volume":"40","author":"Nichols","year":"2022","journal-title":"J Clin Oncol"},{"issue":"10","key":"ooi230029r5","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1016\/S1470-2045(19)30410-3","article-title":"Radiotherapy versus transoral robotic surgery and neck dissection for oropharyngeal squamous cell carcinoma (ORATOR): an open-label, phase 2, randomised trial.","volume":"20","author":"Nichols","year":"2019","journal-title":"Lancet Oncol"},{"issue":"17","key":"ooi230029r6","doi-asserted-by":"publisher","first-page":"3485","DOI":"10.1200\/JCO.2004.03.025","article-title":"How accurate is clinician reporting of chemotherapy adverse effects? a comparison with patient-reported symptoms from the Quality-of-Life Questionnaire C30.","volume":"22","author":"Fromme","year":"2004","journal-title":"J Clin Oncol"},{"issue":"6","key":"ooi230029r7","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1001\/jamaoto.2016.0656","article-title":"Comparison of patient- and practitioner-reported toxic effects associated with chemoradiotherapy for head and neck cancer.","volume":"142","author":"Falchook","year":"2016","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"7","key":"ooi230029r8","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1007\/s11136-011-0031-4","article-title":"Reliability of adverse symptom event reporting by clinicians.","volume":"21","author":"Atkinson","year":"2012","journal-title":"Qual Life Res"},{"issue":"6","key":"ooi230029r9","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.1097\/NCC.0b013e318269040f","article-title":"Comparison between patient-reported and clinician-observed symptoms in oncology.","volume":"36","author":"Xiao","year":"2013","journal-title":"Cancer Nurs"},{"key":"ooi230029r10","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2021.105309","article-title":"Patient-reported quality of life and symptom burden measures in human papillomavirus associated oropharyngeal cancer\u2014a review of the literature and PRO methodology.","volume":"118","author":"McDowell","year":"2021","journal-title":"Oral Oncol"},{"issue":"1","key":"ooi230029r13","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1001\/archotol.128.1.44","article-title":"Development and validation of the neck dissection impairment index: a quality of life measure.","volume":"128","author":"Taylor","year":"2002","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"10","key":"ooi230029r14","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1001\/archotol.131.10.851","article-title":"Development and validation of the effectiveness of [corrected] auditory rehabilitation scale.","volume":"131","author":"Yueh","year":"2005","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"1","key":"ooi230029r15","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1002\/(ISSN)1097-0142","article-title":"Interpreting clinically significant changes in patient-reported outcomes.","volume":"110","author":"Ringash","year":"2007","journal-title":"Cancer"},{"issue":"10","key":"ooi230029r16","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1002\/(ISSN)1097-0347","article-title":"Measuring head and neck cancer symptom burden: the development and validation of the M. D. Anderson symptom inventory, head and neck module.","volume":"29","author":"Rosenthal","year":"2007","journal-title":"Head Neck"},{"issue":"5","key":"ooi230029r17","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1016\/j.ijrobp.2021.09.012","article-title":"A randomized trial of radiotherapy vs. trans-oral surgery for treatment de-escalation in HPV-associated oropharyngeal squamous cell carcinoma (ORATOR2).","volume":"111","author":"Ma","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ooi230029r18","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.oraloncology.2019.01.020","article-title":"Patient-reported outcomes of symptom burden in patients receiving surgical or nonsurgical treatment for low-intermediate risk oropharyngeal squamous cell carcinoma: a comparative analysis of a prospective registry.","volume":"91","author":"Amit","year":"2019","journal-title":"Oral Oncol"},{"issue":"10","key":"ooi230029r19","doi-asserted-by":"publisher","first-page":"2883","DOI":"10.1002\/hed.v43.10","article-title":"Dysphagia profiles after primary transoral robotic surgery or radiation for oropharyngeal cancer: a registry analysis.","volume":"43","author":"Barbon","year":"2021","journal-title":"Head Neck"},{"issue":"6","key":"ooi230029r20","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1001\/jamaoto.2015.0347","article-title":"Transoral robotic surgery alone for oropharyngeal cancer: quality-of-life outcomes.","volume":"141","author":"Choby","year":"2015","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"1","key":"ooi230029r21","first-page":"18","article-title":"Long-term functional and quality-of-life outcomes after transoral robotic surgery in patients with oropharyngeal cancer.","volume":"144","author":"Achim","year":"2018","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"2","key":"ooi230029r22","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1200\/JCO.21.01752","article-title":"Phase II randomized trial of transoral surgery and low-dose intensity modulated radiation therapy in resectable p16+ locally advanced oropharynx cancer: an ECOG-ACRIN Cancer Research Group Trial (E3311).","volume":"40","author":"Ferris","year":"2022","journal-title":"J Clin Oncol"},{"issue":"6","key":"ooi230029r23","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1002\/lary.v131.6","article-title":"Socioeconomic status drives racial disparities in HPV-negative head and neck cancer outcomes.","volume":"131","author":"Lenze","year":"2021","journal-title":"Laryngoscope"},{"issue":"10","key":"ooi230029r24","doi-asserted-by":"publisher","first-page":"3001","DOI":"10.1002\/hed.v43.10","article-title":"Effect of socioeconomic status on survival in patients with head and neck cancer.","volume":"43","author":"Weizman","year":"2021","journal-title":"Head Neck"},{"issue":"4","key":"ooi230029r25","doi-asserted-by":"publisher","first-page":"313","DOI":"10.3390\/oral1040031","article-title":"Social determinants of health-related quality of life outcomes for head and neck cancer patients.","volume":"1","author":"Rogers","year":"2021","journal-title":"Oral"},{"issue":"5","key":"ooi230029r26","doi-asserted-by":"publisher","first-page":"759","DOI":"10.3109\/0284186X.2014.998279","article-title":"Socioeconomic position and stage at diagnosis of head and neck cancer\u2014a nationwide study from DAHANCA.","volume":"54","author":"Olsen","year":"2015","journal-title":"Acta Oncol"},{"key":"ooi230029r27","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.radonc.2021.01.013","article-title":"Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 107 randomized trials and 19,805 patients, on behalf of MACH-NC Group.","volume":"156","author":"Lacas","year":"2021","journal-title":"Radiother Oncol"},{"issue":"10","key":"ooi230029r28","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1002\/(ISSN)1097-0347","article-title":"Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501).","volume":"27","author":"Bernier","year":"2005","journal-title":"Head Neck"},{"issue":"14","key":"ooi230029r29","doi-asserted-by":"publisher","first-page":"2453","DOI":"10.1002\/cncr.v127.14","article-title":"The impact of induction and\/or concurrent chemoradiotherapy on acute and late patient-reported symptoms in oropharyngeal cancer: application of a mixed-model analysis of a prospective observational cohort registry.","volume":"127","author":"van Dijk","year":"2021","journal-title":"Cancer"},{"issue":"1","key":"ooi230029r30","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/S0167-8140(02)00173-1","article-title":"Sensori-neural hearing loss after radiotherapy for nasopharyngeal carcinoma: individualized risk estimation.","volume":"65","author":"Honor\u00e9","year":"2002","journal-title":"Radiother Oncol"},{"issue":"5","key":"ooi230029r31","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1016\/j.ijrobp.2007.01.042","article-title":"Risk factors of ototoxicity after cisplatin-based chemo-irradiation in patients with locally advanced head-and-neck cancer: a multivariate analysis.","volume":"68","author":"Zuur","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"2","key":"ooi230029r32","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/S0360-3016(96)00302-1","article-title":"Sensorineural hearing loss in patients treated for nasopharyngeal carcinoma: a prospective study of the effect of radiation and cisplatin treatment.","volume":"36","author":"Kwong","year":"1996","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"ooi230029r33","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/j.jmir.2013.11.003","article-title":"Sensorineural hearing loss after treatment for head and neck cancer: a review of the literature.","volume":"45","author":"Shorter","year":"2014","journal-title":"J Med Imaging Radiat Sci"},{"issue":"2","key":"ooi230029r34","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1002\/hed.v37.2","article-title":"Sensorineural hearing loss in patients with head and neck cancer after chemoradiotherapy and radiotherapy: a systematic review of the literature.","volume":"37","author":"Theunissen","year":"2015","journal-title":"Head Neck"},{"key":"ooi230029r35","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.oraloncology.2017.05.009","article-title":"Long-term toxicities in 10-year survivors of radiation treatment for head and neck cancer.","volume":"71","author":"Dong","year":"2017","journal-title":"Oral Oncol"},{"issue":"1","key":"ooi230029r36","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/s12885-021-09155-y","article-title":"Exercise-based dysphagia rehabilitation for adults with oesophageal cancer: a systematic review.","volume":"22","author":"Gillman","year":"2022","journal-title":"BMC Cancer"},{"issue":"4","key":"ooi230029r37","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1002\/cncr.v128.4","article-title":"Transoral robotic surgery adoption and safety in treatment of oropharyngeal cancers.","volume":"128","author":"Oliver","year":"2022","journal-title":"Cancer"},{"key":"ooi230029r38","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.oraloncology.2019.08.007","article-title":"Treatment trends in oropharyngeal carcinoma: surgical technology meets the epidemic.","volume":"97","author":"Gal","year":"2019","journal-title":"Oral Oncol"},{"issue":"2","key":"ooi230029r39","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/S1470-2045(10)70290-4","article-title":"Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial.","volume":"12","author":"Nutting","year":"2011","journal-title":"Lancet Oncol"},{"issue":"5","key":"ooi230029r40","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1002\/cncr.28372","article-title":"Improved survival using intensity-modulated radiation therapy in head and neck cancers: a SEER-Medicare analysis.","volume":"120","author":"Beadle","year":"2014","journal-title":"Cancer"},{"key":"ooi230029r12","volume-title":"Mail and Internet Surveys: The Tailored Design Method","author":"Dillman","year":"2000","edition":"2nd ed"},{"key":"ooi230029r1","unstructured":"Head and neck cancer. National Comprehensive Cancer Network. Published April 26, 2022. Accessed May 15, 2022. https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/head-and-neck.pdf"},{"key":"ooi230029r11","unstructured":"Texas Cancer Registry. Texas Health and Human Services. 2023. Accessed February 26, 2023. https:\/\/www.dshs.texas.gov\/texas-cancer-registry"}],"container-title":["JAMA Otolaryngology\u2013Head &amp; Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/articlepdf\/2806315\/jamaotolaryngology_dohopolski_2023_oi_230029_1691528816.59259.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T15:12:39Z","timestamp":1691680359000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/fullarticle\/2806315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,1]]},"references-count":40,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoto.2023.1323","relation":{},"ISSN":["2168-6181"],"issn-type":[{"value":"2168-6181","type":"print"}],"subject":[],"published":{"date-parts":[[2023,8,1]]}}}