{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:55:50Z","timestamp":1768510550054,"version":"3.49.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>The exact mechanism of sarcopenic dysphagia following esophagectomy, which is associated with reduced pharyngeal contraction, remains unclear. This study measured the maximum pharyngeal constriction area normalized (MPCAn) as a potential indicator of post-esophagectomy sarcopenic dysphagia. Videofluoroscopic examination of swallowing study was conducted in 134 patients with suspected dysphagia following esophagectomy, defined as a score of \u22653 in the 8-point penetration\u2013aspiration scale. The area under the receiver operating characteristic curve of MPCAn was applied to detect dysphagia in comparison with duration and distance of hyoid bone elevation and upper esophageal sphincter opening width. Cutoff MPCAn values were used to compare patient characteristics, including body composition and physical function. Multivariate analysis was employed to evaluate the association of MPCAn with postoperative pneumonia and recurrent laryngeal nerve paralysis (RLNP). MPCAn was an important predictor of dysphagia, compared to the three videofluoroscopic examination of swallowing study parameters (0.874 vs. 0.784, P\u2009=\u20090.006). MPCAn was an independent risk factor for dysphagia at a cutoff value of 14. The patients with a larger MPCAn (N\u2009=\u200958) had significantly lower body mass index and worse timed Up and Go test results than those with a smaller MPCAn (N\u2009=\u200976) (19.76 vs. 21.56\u00a0kg\/m2, P\u2009=\u20090.021 and 7.25 vs. 5.85\u00a0s; P\u2009=\u20090.014, respectively). MPCAn was significantly associated with late-onset pneumonia (odds ratio 2.58, 95% 1.03\u20136.46; P\u2009=\u20090.044) and was the only significant risk factor for dysphagia in those without RLNP (odds ratio 35.90, 95% confidence interval 6.20\u2013205; P\u2009&amp;lt;\u20090.001). MPCAn was a useful predictor of post-esophagectomy sarcopenic dysphagia, especially in patients without RLNP, and was significantly associated with late-onset pneumonia.<\/jats:p>","DOI":"10.1093\/dote\/doaf134","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T12:50:37Z","timestamp":1766235037000},"source":"Crossref","is-referenced-by-count":0,"title":["Maximum pharyngeal constriction area: an independent predictor of sarcopenic dysphagia after esophageal cancer surgery"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2991-985X","authenticated-orcid":false,"given":"Jun","family":"Takatsu","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, Aichi Cancer Center Hospital , Nagoya ,","place":["Japan"]},{"name":"Department of Health Sciences, Aichi-Gakuin University , Nisshin ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiji","family":"Higaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Aichi Cancer Center Hospital , Nagoya ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosuke","family":"Inada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Aichi Cancer Center Hospital , Nagoya ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Aichi Cancer Center Hospital , Nagoya ,","place":["Japan"]},{"name":"Department of Orthopedic Surgery, Aichi Cancer Center Hospital , Nagoya ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Aichi Cancer Center Hospital , Nagoya ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Aichi Cancer Center Hospital , Nagoya ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaisuke","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Aichi-Gakuin University , Nisshin ,","place":["Japan"]},{"name":"Department of Neurology and Rehabilitation, Kakamigahara Rehabilitation Hospital, Medical Corporation Seidoukai , Kakamigahara ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiyori","family":"Makino","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Aichi-Gakuin University , Nisshin ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Aichi-Gakuin University , Nisshin ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Aichi-Gakuin University , Nisshin ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6976-9753","authenticated-orcid":false,"given":"Tetsuya","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Aichi Cancer Center Hospital , Nagoya ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"2026011501043390500_ref1","doi-asserted-by":"publisher","first-page":"doy050","DOI":"10.1093\/dote\/doy050","article-title":"Presentation of oropharyngeal dysphagia and rehabilitative intervention following esophagectomy: a systematic review","volume":"31","author":"Kaneoka","year":"2018","journal-title":"Dis Esophagus"},{"key":"2026011501043390500_ref2","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1093\/ageing\/afq034","article-title":"Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People","volume":"39","author":"Cruz-Jentoft","year":"2010","journal-title":"Age Ageing"},{"key":"2026011501043390500_ref3","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1111\/ggi.13591","article-title":"Sarcopenia and dysphagia: position paper by four professional organizations","volume":"19","author":"Fujishima","year":"2019","journal-title":"Geriatr Gerontol Int"},{"key":"2026011501043390500_ref4","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1002\/ags3.12603","article-title":"Clinical significance of sarcopenic dysphagia for patients with esophageal cancer undergoing esophagectomy: a review","volume":"6","author":"Oguma","year":"2022","journal-title":"Ann Gastroenterol Surg"},{"key":"2026011501043390500_ref5","doi-asserted-by":"crossref","first-page":"doaa121","DOI":"10.1093\/dote\/doaa121","article-title":"Association of preoperative sarcopenia with postoperative dysphagia in patients with thoracic esophageal cancer","volume":"34","author":"Mayanagi","year":"2021","journal-title":"Dis Esophagus"},{"key":"2026011501043390500_ref6","doi-asserted-by":"publisher","first-page":"63","DOI":"10.17264\/stmarieng.10.63","article-title":"Relation between decrease in geniohyoid muscle mass and dysphagia after surgery for thoracic esophageal cancer","volume":"10","author":"Katsumata","year":"2019","journal-title":"J St Marianna Univ"},{"key":"2026011501043390500_ref7","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1007\/s10388-019-00668-x","article-title":"Change in tongue pressure and related factors after esophagectomy: a short-term, longitudinal study","volume":"16","author":"Yokoi","year":"2019","journal-title":"Esophagus"},{"key":"2026011501043390500_ref8","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s00455-011-9351-3","article-title":"Analysis of video fluoroscopic swallowing study in patients with vocal cord paralysis","volume":"27","author":"Jang","year":"2012","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref9","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/s10388-023-01041-9","article-title":"Critical swallowing functions contributing to dysphagia in patients with recurrent laryngeal nerve paralysis after esophagectomy","volume":"21","author":"Takatsu","year":"2024","journal-title":"Esophagus"},{"key":"2026011501043390500_ref10","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s00455-020-10095-1","article-title":"Relationship between tongue pressure and pharyngeal function assessed using high-resolution manometry in older dysphagia patients with sarcopenia: a pilot study","volume":"36","author":"Kunieda","year":"2021","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref11","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s00455-015-9606-5","article-title":"The relationship between pharyngeal constriction and post-swallow residue","volume":"30","author":"Stokely","year":"2015","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref12","doi-asserted-by":"publisher","first-page":"2870","DOI":"10.1044\/2020_JSLHR-19-00220","article-title":"Mechanisms of impaired swallowing on thin liquids following radiation treatment for oropharyngeal cancer","volume":"63","author":"Barbon","year":"2020","journal-title":"J Speech Lang Hear Res"},{"key":"2026011501043390500_ref13","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1007\/s00455-013-9459-8","article-title":"The relationship between residue and aspiration on the subsequent swallow: an application of the normalized residue ratio scale","volume":"28","author":"Molfenter","year":"2013","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref14","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1007\/s00455-019-10052-7","article-title":"Pharyngeal area changes in Parkinson\u2019s disease and its effect on swallowing safety, efficiency and kinematics","volume":"35","author":"Curtis","year":"2020","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref15","doi-asserted-by":"publisher","first-page":"e13450","DOI":"10.1111\/nmo.13450","article-title":"Reduced pharyngeal constriction is associated with impaired swallowing efficiency in amyotrophic lateral sclerosis (ALS)","volume":"30","author":"Waito","year":"2018","journal-title":"Neurogastroenterol Motil"},{"key":"2026011501043390500_ref16","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/BF00417897","article-title":"A penetration-aspiration scale","volume":"11","author":"Rosenbek","year":"1996","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref17","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1007\/s00455-019-10064-3","article-title":"Use of the penetration-aspiration scale in dysphagia research: a systematic review","volume":"35","author":"Borders","year":"2020","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref18","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1245\/s10434-021-10867-5","article-title":"Significance of antimicrobial prophylaxis for the prevention of early-onset pneumonia after radical esophageal cancer resection: a retrospective analysis of 356 patients undergoing thoracoscopic esophagectomy","volume":"29","author":"Higaki","year":"2022","journal-title":"Ann Surg Oncol"},{"key":"2026011501043390500_ref19","doi-asserted-by":"publisher","first-page":"doaa094","DOI":"10.1093\/dote\/doaa094","article-title":"Clinical benefits of a swallowing intervention for esophageal cancer patients after esophagectomy","volume":"34","author":"Takatsu","year":"2021","journal-title":"Dis Esophagus"},{"key":"2026011501043390500_ref20","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1007\/s00455-015-9670-x","article-title":"Swallowing kinematics and factors associated with laryngeal penetration and aspiration in stroke survivors with dysphagia","volume":"31","author":"Seo","year":"2016","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref21","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1007\/s00455-005-0029-6","article-title":"Temporal measurements of pharyngeal swallowing in normal populations","volume":"20","author":"Kim","year":"2005","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref22","doi-asserted-by":"publisher","first-page":"15644","DOI":"10.1038\/s41598-019-52246-x","article-title":"Application of automatic kinematic analysis program for the evaluation of dysphagia in ALS patients","volume":"9","author":"Lee","year":"2019","journal-title":"Sci Rep"},{"key":"2026011501043390500_ref23","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1097\/00005537-200202000-00024","article-title":"Videofluoroscopic upper esophageal sphincter function in elderly dysphagic patients","volume":"112","author":"Kendall","year":"2002","journal-title":"Laryngoscope"},{"key":"2026011501043390500_ref24","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1007\/s00455-012-9426-9","article-title":"Image-based measurement of post-swallow residue: the normalized residue ratio scale","volume":"28","author":"William","year":"2013","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref25","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.1001\/archotol.127.10.1224","article-title":"Hyoid movement during swallowing in older patients with dysphagia","volume":"127","author":"Kendall","year":"2001","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"2026011501043390500_ref26","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1044\/jslhr.4305.1264","article-title":"Temporal and biomechanical characteristics of oropharyngeal swallow in younger and older men","volume":"43","author":"Logemann","year":"2000","journal-title":"J Speech Lang Hear Res"},{"key":"2026011501043390500_ref27","doi-asserted-by":"publisher","first-page":"2121","DOI":"10.1002\/lary.31149","article-title":"A novel quantitative measure of pharyngeal shortening","volume":"134","author":"Leonard","year":"2024","journal-title":"Laryngoscope"},{"key":"2026011501043390500_ref28","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1007\/s00455-016-9744-4","article-title":"Modulation of upper esophageal sphincter (UES) relaxation and opening during volume swallowing","volume":"32","author":"Cock","year":"2017","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref29","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1002\/lio2.273","article-title":"Functional modules of pharyngeal swallowing mechanics","volume":"4","author":"Hosseini","year":"2019","journal-title":"Laryngoscope Investig Otolaryngol"},{"key":"2026011501043390500_ref30","doi-asserted-by":"publisher","first-page":"393","DOI":"10.2214\/ajr.178.2.1780393","article-title":"Videofluoroscopic assessment of patients with dysphagia: pharyngeal retention is a predictive factor for aspiration","volume":"178","author":"Eisenhuber","year":"2002","journal-title":"AJR Am J Roentgenol"},{"key":"2026011501043390500_ref31","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1007\/s00455-011-9392-7","article-title":"Structural analysis of muscles elevating the hyolaryngeal complex","volume":"27","author":"Pearson","year":"2012","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref32","first-page":"4249","article-title":"Videofluoroscopic evaluation in oropharyngeal swallowing after radical esophagectomy with lymphadenectomy for esophageal cancer","volume":"27","author":"Kato","year":"2007","journal-title":"Anticancer Res"},{"key":"2026011501043390500_ref33","doi-asserted-by":"publisher","first-page":"66","DOI":"10.3390\/geriatrics3040066","article-title":"Dysphagia onset in older adults during unrelated hospital admission: quantitative videofluoroscopic measures","volume":"3","author":"Jardine","year":"2018","journal-title":"Geriatrics"},{"key":"2026011501043390500_ref34","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1007\/s00455-023-10618-6","article-title":"Longitudinal analysis of dysphagia and factors related to postoperative pneumonia in patients undergoing esophagectomy for esophageal cancer","volume":"39","author":"Kaneoka","year":"2024","journal-title":"Dysphagia"},{"key":"2026011501043390500_ref35","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1055\/s-0039-1688837","article-title":"Presbyphagia to dysphagia: multiple perspectives and strategies for quality care of older adults","volume":"40","author":"Namasivayam-MacDonald","year":"2019","journal-title":"Semin Speech Lang"},{"key":"2026011501043390500_ref36","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1589\/jpts.30.1357","article-title":"Oropharyngeal swallowing function in patients with presbyphagia","volume":"30","author":"Lee","year":"2018","journal-title":"J Phys Ther Sci"},{"key":"2026011501043390500_ref37","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment","volume":"21","author":"Chen","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"2026011501043390500_ref38","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1002\/jcsm.12958","article-title":"Dose\u2013response relationships of sarcopenia parameters with incident disability and mortality in older Japanese adults","volume":"13","author":"Seino","year":"2022","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"2026011501043390500_ref39","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1152\/jappl.1999.86.1.188","article-title":"Muscle quality. I. Age-associated differences between arm and leg muscle groups","volume":"86","author":"Lynch","year":"1999","journal-title":"J Appl Physiol"},{"key":"2026011501043390500_ref40","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1089\/sur.2015.158","article-title":"Preventive effect on post-operative pneumonia of oral health care among patients who undergo esophageal resection: a multi-center retrospective study","volume":"17","author":"Soutome","year":"2016","journal-title":"Surg Infect (Larchmt)"},{"key":"2026011501043390500_ref41","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1097\/SLA.0000000000002611","article-title":"Benchmarking complications associated with esophagectomy","volume":"269","author":"Low","year":"2019","journal-title":"Ann Surg"},{"key":"2026011501043390500_ref42","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1007\/s10388-022-00925-6","article-title":"Handgrip strength predicts early postoperative dysphagia after thoracoscopic\u2013laparoscopic esophagectomy in male patients with esophageal cancer","volume":"19","author":"Kurita","year":"2022","journal-title":"Esophagus"},{"key":"2026011501043390500_ref43","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1044\/nsshla_12_38","volume-title":"Evaluation and Treatment of Swallowing Disorders","author":"Logemann","year":"1983"},{"key":"2026011501043390500_ref44","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.surg.2021.03.051","article-title":"Postoperative pneumonia in the acute phase is an import ant prognostic factor in patients with esophageal cancer","volume":"170","author":"Tanaka","year":"2021","journal-title":"Surgery"},{"key":"2026011501043390500_ref45","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.jointm.2023.12.009","article-title":"Severe aspiration pneumonia in the elderly","volume":"4","author":"Ocrospoma","year":"2024","journal-title":"J Intensive Med"},{"key":"2026011501043390500_ref46","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.jelekin.2015.11.009","article-title":"Kinematic analysis of swallowing in the patients with esophagectomy for esophageal cancer","volume":"28","author":"Kim","year":"2016","journal-title":"J Electromyogr Kinesiol"}],"container-title":["Diseases of the Esophagus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/39\/1\/doaf134\/66417709\/doaf134.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/39\/1\/doaf134\/66417709\/doaf134.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T06:04:55Z","timestamp":1768457095000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/dote\/article\/doi\/10.1093\/dote\/doaf134\/8425995"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,9]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,9]]}},"URL":"https:\/\/doi.org\/10.1093\/dote\/doaf134","relation":{},"ISSN":["1120-8694","1442-2050"],"issn-type":[{"value":"1120-8694","type":"print"},{"value":"1442-2050","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2026,1,9]]},"article-number":"doaf134"}}