{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T03:40:14Z","timestamp":1782790814173,"version":"3.54.5"},"reference-count":43,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T00:00:00Z","timestamp":1508716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005193","name":"American Academy of Otolaryngology-Head and Neck Surgery","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005193","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine associations between speech\u2010language pathology (SLP) care and pretreatment variables, short\u2010term and long\u2010term swallowing and airway impairment, and survival in elderly patients treated for oropharyngeal squamous cell cancer (SCCA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective analysis of Surveillance, Epidemiology, and End Results\u2010Medicare data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated longitudinal data from 666 patients diagnosed with oropharyngeal SCCA from 2004 to 2007 using cross\u2010tabulations, multivariate logistic regression, and survival analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SLP care was documented in 25% of patients. High\u2010volume hospital care (odds ratio (OR)\u2009=\u20093.2 [1.0\u201310.0]) and dysphagia during treatment (OR\u2009=\u200913.0 [3.6\u201347.1]) were the only significant predictors of SLP care during the initial treatment period. SLP care was significantly more likely during the first year (OR\u2009=\u20095.3 [3.1\u20139.1]) and second year (OR\u2009=\u20094.5 [2.4\u20138.2]) following initial treatment. Subsequent dysphagia (OR\u2009=\u200932.5 [16.9\u201362.4]), stricture (OR\u2009=\u20092.2 [1.2\u20134.0]), gastrostomy (OR\u2009=\u20091.7 [1.1\u20132.7]), and tracheostomy tube use (OR\u2009=\u20092.4 [1.2\u20134.8]) were significantly associated with long\u2010term SLP care. After controlling for patient, tumor, and treatment\u2010related variables, SLP care was associated with significant relative attenuation of the OR for dysphagia (93%), stricture (35%), weight loss (8%), and airway obstruction (34%). Survival analysis, controlling for all other variables, demonstrated improved survival for patients under SLP care (hazard ratio\u2009=\u20090.73 [0.57\u20130.95]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SLP care is underutilized in elderly oropharyngeal SCCA patients and largely utilized after the onset of impaired airway and swallowing function, but is associated with improved outcomes. These data suggest a need for treatment guidelines that incorporate the routine use of SLP care in this population during the initial treatment period and beyond.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c.<jats:italic>Laryngoscope<\/jats:italic>, 128:1403\u20131411, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26950","type":"journal-article","created":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T06:14:44Z","timestamp":1508739284000},"page":"1403-1411","source":"Crossref","is-referenced-by-count":10,"title":["Speech\u2010language pathology care and short\u2010 and long\u2010term outcomes of oropharyngeal cancer treatment in the elderly"],"prefix":"10.1002","volume":"128","author":[{"given":"Kimberly T.","family":"Webster","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins University Baltimore Maryland U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Tippett","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins University Baltimore Maryland U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa","family":"Simpson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins University Baltimore Maryland U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina","family":"Abrams","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins University Baltimore Maryland U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Pietsch","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins University Baltimore Maryland U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Herbert","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management the Johns Hopkins Bloomberg School of Public Health Baltimore Maryland U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Eisele","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins University Baltimore Maryland U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5134-9307","authenticated-orcid":false,"given":"Christine G.","family":"Gourin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins University Baltimore Maryland U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,10,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912217"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000240182.61922.31"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.8841"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.11.026"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(02)00404-8"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2013.07.010"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.43.6097"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20672"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-013-0376-7"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-014-9519-8"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.06.1954"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25454"},{"key":"e_1_2_6_14_1","unstructured":"NIH.National Cancer Institute Surveillance Epidemiology and End Results Program: Cancer Statistics. 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