{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T23:42:44Z","timestamp":1783208564416,"version":"3.54.6"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T00:00:00Z","timestamp":1521849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"American Academy of Otolaryngology-Head and Neck Surgery Percy Memorial Research Award"},{"name":"American Academy of Otolaryngology- Head and Neck Surgery Percy Memorial Research Award","award":["none"],"award-info":[{"award-number":["none"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine associations between pretreatment variables, short\u2010term and long\u2010term swallowing and airway impairment, and survival in elderly patients (age\u2009&gt;\u200965 years) 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 (SEER)\u2010Medicare data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Longitudinal data from 666 patients diagnosed with oropharyngeal SCCA from 2004 to 2007 were evaluated using cross\u2010tabulations, multivariate logistic regression, and survival analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Dysphagia (odds ratio [OR]\u2009=\u20091.3, 1.0\u20131.7), esophageal stricture (OR\u2009=\u20095.5, 2.6\u201311.9), and airway obstruction (OR\u2009=\u20091.6, 1.1\u20132.2) increased 1 year after treatment. The odds of airway obstruction, esophageal stricture, and pneumonia increased over subsequent years, with significantly increased risk at 5 years for airway obstruction (OR\u2009=\u20093.0, 1.4\u20136.4), pneumonia (OR\u2009=\u20094.5, 1.8\u201311.2), and stricture (OR\u2009=\u20095.5, 1.8\u201317.6). Pretreatment dysphagia was a significant predictor of long\u2010term dysphagia, airway obstruction, and pneumonia. Chemoradiation, advanced stage disease, high\u2010volume hospital care, male sex, and salvage surgery were significant predictors of long\u2010term gastrostomy use. Long\u2010term dysphagia, gastrostomy or tracheostomy dependence, weight loss, airway obstruction, and pneumonia were associated with poorer survival, with tracheostomy dependence (hazard ratio [HR]\u2009=\u20092.2, 1.7\u20132.9) and pneumonia (HR\u2009=\u20092.0, 1.7\u20132.4) associated with the greatest risk of late mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Airway and swallowing impairment is common after treatment of oropharyngeal SCCA in elderly patients, increases over time, and is associated with poorer survival. Patients with pretreatment dysphagia, advanced stage disease, initial treatment with chemoradiation, and salvage surgery represent a high\u2010risk group with an increased risk of disability and death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c. <jats:italic>Laryngoscope<\/jats:italic>, 128:2084\u20132093, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27153","type":"journal-article","created":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T23:51:36Z","timestamp":1521935496000},"page":"2084-2093","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Short\u2010 and long\u2010term outcomes of oropharyngeal cancer care in the elderly"],"prefix":"10.1002","volume":"128","author":[{"given":"Kevin","family":"Motz","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery 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":"Carole","family":"Fakhry","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Quon","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Molecular Radiation Sciences Johns Hopkins University Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunseok","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Oncology Sidney Kimmel Comprehensive Cancer Center Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana P.","family":"Kiess","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Molecular Radiation Sciences Johns Hopkins University 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 Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9499-1516","authenticated-orcid":false,"given":"Wayne M.","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin D.","family":"Frick","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management the Johns Hopkins Bloomberg School of Public Health Baltimore Maryland U.S.A."},{"name":"Johns Hopkins Carey Business School 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 Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,24]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"National Cancer Institute Surveillance Epidemiology and End Results Program: Cancer Statistics. 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