{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:15:22Z","timestamp":1790007322582,"version":"4.0.1"},"reference-count":83,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Total glossectomy (TG) is among the most radical operations in head and neck oncology. While it can achieve local control in advanced oral tongue squamous cell carcinoma, survival and functional outcomes are inconsistently reported, and pooled estimates remain limited. This study aimed to systematically evaluate survival, functional recovery, and prognostic factors following primary TG. Methods: We conducted a proportional meta-analysis of studies reporting outcomes after primary TG for oral tongue squamous cell carcinoma. Studies combining TG with laryngectomy, salvage settings, or second primary tumors were excluded. Two reviewers independently screened, extracted data, and assessed quality with the Newcastle\u2013Ottawa Scale. Pooled 1-, 3-, and 5-year overall survival (OS) with 95% confidence intervals (CIs) was calculated using a random-effects model. Heterogeneity was quantified (Q, \u03c42, I2), and robustness was assessed with sensitivity analyses. Disease-free survival (DFS) and functional outcomes (swallowing, airway, speech) were narratively summarized due to inconsistent reporting. Results: Ten studies (1992\u20132022) comprising 261 patients met the criteria. Pooled OS was 81% (95% CI, 71\u201390) at 1 year, 55% (95% CI, 41\u201368) at 3 years, and 47% (95% CI, 27\u201367) at 5 years, with rising heterogeneity (I2 up to 89%). The post-2000 series showed improved 5-year OS (63%). Adverse prognostic factors included advanced T stage, nodal disease (N+), and positive margins. Functional recovery varied: 15\u201330% remained gastrostomy-dependent and 20\u201325% aspirated, while reconstruction and structured rehabilitation improved outcomes. Conclusions: Survival after TG declines beyond the first year, with under half surviving at 5 years, though modern outcomes appear better. Significant functional morbidity underscores the need for multidisciplinary care. Future biomarker-driven studies should refine patient selection and prognostic assessment.<\/jats:p>","DOI":"10.3390\/diagnostics15222847","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T15:07:31Z","timestamp":1762787251000},"page":"2847","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic Value of Primary Total Glossectomy in Tongue Cancer: A Systematic Review and Meta-Analysis of Survival Outcomes"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4050-9106","authenticated-orcid":false,"given":"M. P.","family":"Sreeram","sequence":"first","affiliation":[{"name":"Department of Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Centre, Bangalore 560004, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1952-4061","authenticated-orcid":false,"given":"Prajwal","family":"Dange","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Centre, Bangalore 560004, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1420-7366","authenticated-orcid":false,"given":"Karthik N.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Centre, Bangalore 560004, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0481-156X","authenticated-orcid":false,"given":"Luiz P.","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery and Otorhinolaryngology Department, A. C. Camargo Cancer Center, Sao Paulo 01509-900, Brazil"},{"name":"Head and Neck Surgery, Faculty of Medicine, University of Sao Paulo, Sao Paulo 05508-020, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7128-5814","authenticated-orcid":false,"given":"Remco","family":"de Bree","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9671-0784","authenticated-orcid":false,"given":"Orlando","family":"Guntinas-Lichius","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital, 07740 Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8247-8002","authenticated-orcid":false,"given":"Alfio","family":"Ferlito","sequence":"additional","affiliation":[{"name":"Coordinator of the International Head and Neck Scientific Group, 35100 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1177\/01945998221098011","article-title":"Changing epidemiology of oral cavity cancer in the united states","volume":"168","author":"Stepan","year":"2023","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"103440","DOI":"10.1016\/j.amjoto.2022.103440","article-title":"Survival, functional, and quality of life outcomes between total glossectomy with and without total laryngectomy: A narrative review","volume":"43","author":"Burnham","year":"2022","journal-title":"Am. J. Otolaryngol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"106415","DOI":"10.1016\/j.oraloncology.2023.106415","article-title":"Functional outcomes and complications of total glossectomy with laryngeal preservation and flap reconstruction: A systematic review and meta-analysis","volume":"141","author":"Russo","year":"2023","journal-title":"Oral Oncol."},{"key":"ref_4","first-page":"160","article-title":"A re-evaluation of radical total glossectomy","volume":"22","author":"Davidson","year":"1993","journal-title":"J. Otolaryngol."},{"key":"ref_5","first-page":"877","article-title":"Speech intelligibility after glossectomy and speech rehabilitation","volume":"127","author":"Furia","year":"2001","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/micr.22440","article-title":"Long-term functional outcomes after total tongue reconstruction: Consideration of flap types, volume, and functional results","volume":"37","author":"Jeong","year":"2017","journal-title":"Microsurgery"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"g7647","DOI":"10.1136\/bmj.g7647","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation","volume":"349","author":"Shamseer","year":"2015","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"Shea","year":"2017","journal-title":"BMJ."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Lo, C.K.L., Mertz, D., and Loeb, M. (2014). Newcastle-Ottawa Scale: Comparing reviewers\u2019 to authors\u2019 assessments. BMC Med. Res. Methodol., 14.","DOI":"10.1186\/1471-2288-14-45"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Borenstein, M., Hedges, L.V., Higgins, J.P.T., and Rothstein, H.R. (2009). Random-Effects Model. Introduction to Meta-Analysis, John Wiley & Sons, Ltd.. Available online: https:\/\/onlinelibrary.wiley.com\/doi\/abs\/10.1002\/9780470743386.ch12.","DOI":"10.1002\/9780470743386"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jrsm.1164","article-title":"Methods to estimate the between-study variance and its uncertainty in meta-analysis","volume":"7","author":"Veroniki","year":"2016","journal-title":"Res. Synth. Methods"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Kossmeier, M., Tran, U.S., and Voracek, M. (2020). Charting the landscape of graphical displays for meta-analysis and systematic reviews: A comprehensive review, taxonomy, and feature analysis. BMC Med. Res. Methodol., 20.","DOI":"10.1186\/s12874-020-0911-9"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1002\/jrsm.11","article-title":"Outlier and influence diagnostics for meta-analysis","volume":"1","author":"Viechtbauer","year":"2010","journal-title":"Res. Synth. Methods"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1214\/12-AOS978","article-title":"Perturbation and scaled Cook\u2019s distance","volume":"40","author":"Zhu","year":"2012","journal-title":"Ann. Stat."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13643-015-0004-8","article-title":"Quantifying the risk of error when interpreting funnel plots","volume":"4","author":"Simmonds","year":"2015","journal-title":"Syst. Rev."},{"key":"ref_17","first-page":"40","article-title":"meta: An R Package for Meta-Analysis","volume":"7","author":"Schwarzer","year":"2007","journal-title":"R. News"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1288\/00005537-199212000-00011","article-title":"Advanced carcinoma of the tongue: Total glossectomy without total laryngectomy. Review of 80 cases","volume":"102","author":"Gehanno","year":"1992","journal-title":"Laryngoscope"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/S0964-1955(96)00028-0","article-title":"Major glossectomy: End results of 106 cases","volume":"32","author":"Magrin","year":"1996","journal-title":"Eur. J. Cancer Part B Oral Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1097\/00005537-199710000-00005","article-title":"Survival, function, and quality of life after total glossectomy","volume":"107","author":"Ruhl","year":"1997","journal-title":"Laryngoscope"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1046\/j.1445-2197.2004.02912.x","article-title":"Total glossectomy: Is it justified?","volume":"74","author":"Bova","year":"2004","journal-title":"ANZ J. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1177\/0194599811412724","article-title":"Functional and survival outcomes in patients undergoing total glossectomy compared with total laryngoglossectomy","volume":"145","author":"Sinclair","year":"2011","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1002\/micr.20922","article-title":"Total or subtotal glossectomy with microsurgical reconstruction: Functional and oncological results","volume":"31","author":"Vega","year":"2011","journal-title":"Microsurgery"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.bjoms.2012.07.009","article-title":"Total glossectomy with preservation of the larynx: Oncological and functional results","volume":"51","author":"Navach","year":"2013","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_25","first-page":"4233","article-title":"Total Glossectomy Without Laryngectomy for advanced squamous cell Cancer of the tongue: Functional and oncological results","volume":"37","author":"Reiter","year":"2017","journal-title":"Anticancer Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1002\/lary.27579","article-title":"Total glossectomy with free flap reconstruction: Twenty-year experience at a tertiary medical center","volume":"129","author":"Han","year":"2019","journal-title":"Laryngoscope"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2626","DOI":"10.1016\/j.jfma.2022.07.007","article-title":"An alternative surgical technique for advanced tongue\/tongue base cancer without free flap reconstruction","volume":"121","author":"Huang","year":"2022","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1097\/PRS.0000000000002766","article-title":"Health-related quality of life following reconstruction for common head and neck surgical defects","volume":"138","author":"Cohen","year":"2016","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Grammatica, A., Piazza, C., Ferrari, M., Verzeletti, V., Paderno, A., Mattavelli, D., Schreiber, A., Lombardi, D., Fazio, E., and Gazzini, L. (2021). Step-by-step cadaver dissection and surgical technique for compartmental tongue and floor of mouth resection. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.613945"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1002\/hed.25466","article-title":"Classification of GLOSSECTOMIES: Proposal for tongue cancer resections","volume":"41","author":"Ansarin","year":"2019","journal-title":"Head Neck"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.oraloncology.2010.12.006","article-title":"Compartmental tongue surgery: Long term oncologic results in the treatment of tongue cancer","volume":"47","author":"Calabrese","year":"2011","journal-title":"Oral Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s00405-024-08929-x","article-title":"Role of midline raphe in compartmental surgery for squamous cell carcinoma of the tongue","volume":"282","author":"Alberto","year":"2025","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"106609","DOI":"10.1016\/j.oraloncology.2023.106609","article-title":"Margin distance in oral tongue cancer surgery: A systematic review of survival and recurrence outcomes","volume":"147","author":"Spence","year":"2023","journal-title":"Oral Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4103\/jhnps.jhnps_23_20","article-title":"Total glossectomy: Technique review","volume":"8","author":"Neelakantan","year":"2020","journal-title":"J. Head Neck Physicians Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e18027","DOI":"10.1200\/JCO.2025.43.16_suppl.e18027","article-title":"Radical surgery with adjuvant therapy in advanced oral tongue cancer: Survival trends and functional outcomes","volume":"43","author":"Nair","year":"2025","journal-title":"J. Clin. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.bjorl.2019.02.005","article-title":"Functional outcomes and survival of patients with oral and oropharyngeal cancer after total glossectomy","volume":"86","author":"Costa","year":"2020","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"E2004","DOI":"10.1002\/hed.24369","article-title":"Indications, reconstructive techniques, and results for total glossectomy","volume":"38","author":"Mazarro","year":"2016","journal-title":"Head Neck"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1002\/hed.1092","article-title":"Surgical treatment of squamous cell carcinoma of the base of tongue","volume":"23","author":"Gourin","year":"2001","journal-title":"Head Neck"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1007\/s00455-020-10224-w","article-title":"Volume and location of the defect as predictors of swallowing outcome after glossectomy: Correlation with a classification","volume":"36","author":"Bhattacharya","year":"2021","journal-title":"Dysphagia"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"105896","DOI":"10.1016\/j.oraloncology.2022.105896","article-title":"Salvage total glossectomy and total glosso-laryngectomy: Are they worth it? A GETTEC french multicenter study","volume":"130","author":"Mazerolle","year":"2022","journal-title":"Oral Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"106301","DOI":"10.1016\/j.oraloncology.2022.106301","article-title":"Survival and functional outcomes after total glossectomy with total laryngectomy: Case series from a high-volume tertiary institution","volume":"137","author":"Burnham","year":"2023","journal-title":"Oral Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1007\/s00405-024-09059-0","article-title":"Five-year long-term functional and quality of life outcomes in total glossectomy survivors","volume":"282","author":"Nemade","year":"2025","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1001\/jamaoto.2015.1463","article-title":"Long-term functional outcomes of total glossectomy with or without total laryngectomy","volume":"141","author":"Lin","year":"2015","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1002\/hed.10015","article-title":"Functional status after primary surgical therapy for squamous cell carcinoma of the base of the tongue","volume":"24","author":"Friedlander","year":"2002","journal-title":"Head Neck"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1093\/jjco\/hyl099","article-title":"Long-term functional outcome of brachytherapy for carcinoma of the mobile tongue: Focus on the atrophic change of irradiated tongue","volume":"36","author":"Urashima","year":"2006","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"9198","DOI":"10.1245\/s10434-025-17762-3","article-title":"Functional outcomes after subtotal\/total glossectomy with microsurgical reconstruction: A multicenter prospective observational study in japan","volume":"32","author":"Araki","year":"2025","journal-title":"Ann. Surg. Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1002\/hed.20804","article-title":"Functional outcome after total and subtotal glossectomy with free flap reconstruction","volume":"30","author":"Yanai","year":"2008","journal-title":"Head Neck"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.ijom.2024.07.005","article-title":"Functional outcomes and survival after total glossectomy with laryngectomy: A systematic review","volume":"54","author":"Weyh","year":"2025","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1007\/BF00301917","article-title":"Dysphagia following head and neck cancer surgery","volume":"9","author":"Kronenberger","year":"1994","journal-title":"Dysphagia"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"106596","DOI":"10.1016\/j.oraloncology.2023.106596","article-title":"Functional considerations between flap and non-flap reconstruction in oral tongue cancer: A systematic review","volume":"147","author":"Cortina","year":"2023","journal-title":"Oral Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"3751","DOI":"10.1007\/s00405-017-4683-8","article-title":"Long-term functional outcomes after resection of tongue cancer: Determining the optimal reconstruction method","volume":"274","author":"Ji","year":"2017","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"106434","DOI":"10.1016\/j.oraloncology.2023.106434","article-title":"Quality of life and decisional regret after total glossectomy with laryngectomy: A single-institution case series","volume":"142","author":"Amechi","year":"2023","journal-title":"Oral Oncol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1007\/s10006-025-01471-y","article-title":"Head and neck related quality of life following glossectomy among tongue cancer patients: A systematic review and meta-analysis","volume":"29","author":"Tundealao","year":"2025","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1055\/s-0040-1709493","article-title":"Analysis of speech and functional outcomes in tongue reconstruction after hemiglossectomy","volume":"36","author":"Yi","year":"2020","journal-title":"J. Reconstr. Microsurg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1097\/00006534-199912000-00011","article-title":"Functional reconstruction of swallowing and articulation after total glossectomy without laryngectomy: Money pouch-like reconstruction method using rectus abdominis myocutaneous flap","volume":"104","author":"Kiyokawa","year":"1999","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1097\/00005537-200305000-00024","article-title":"Analysis of the relations between the shape of the reconstructed tongue and postoperative functions after subtotal or total glossectomy","volume":"113","author":"Kimata","year":"2003","journal-title":"Laryngoscope"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"107363","DOI":"10.1016\/j.oraloncology.2025.107363","article-title":"Long-term health-related quality of life in oral cancer survivors following microvascular tongue reconstruction","volume":"166","author":"Tonsbeek","year":"2025","journal-title":"Oral Oncol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"E52","DOI":"10.1002\/lary.28667","article-title":"Swallowing pressure variability as a function of pharyngeal region, bolus volume, age, and sex","volume":"131","author":"Jones","year":"2021","journal-title":"Laryngoscope"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jpra.2024.07.005","article-title":"The \u201cGhost shaped\u201d antero-lateral thigh flap for total tongue reconstruction: A case report","volume":"41","author":"Schonauer","year":"2024","journal-title":"JPRAS Open"},{"key":"ref_60","first-page":"4017","article-title":"Water swallow screening test for patients after surgery for head and neck cancer: Early identification of dysphagia, aspiration and limitations of oral intake","volume":"33","author":"Hey","year":"2013","journal-title":"Anticancer Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1007\/s40136-023-00445-6","article-title":"Dysphagia advances in head and neck cancer","volume":"11","author":"Patterson","year":"2023","journal-title":"Curr. Otorhinolaryngol. Rep."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1001\/archotol.133.12.1289","article-title":"Aspiration in chemoradiated patients with head and neck cancer","volume":"133","author":"Langerman","year":"2007","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"de Carvalho, M.I., Gatti, M., Guedes, R.L.V., Froes, R.C.F., Costa, D.R., da Silva Vitor, J., da Silva Santos, P.S., and Berretin-Felix, G. (2021). Swallowing, nutritional status, and salivary flow in patients after head and neck cancer treatment, a pilot study. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-99208-w"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.oraloncology.2015.10.015","article-title":"Swallowing outcome measures in head and neck cancer\u2014How do they compare?","volume":"52","author":"Pedersen","year":"2016","journal-title":"Oral Oncol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"395","DOI":"10.14639\/0392-100X-829","article-title":"Comparison between videofluoroscopy, fiberoptic endoscopy and scintigraphy for diagnosis of oro-pharyngeal dysphagia","volume":"36","author":"Fattori","year":"2016","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Vester, S., Muhr, A., Meier, J., S\u00fc\u00df, C., Kummer, P., and K\u00fcnzel, J. (2023). Prehabilitation of Dysphagia in the Therapy of Head and Neck Cancer\u2014A Systematic Review of the Literature and Evidence Evaluation. Front. Oncol., 13, Available online: https:\/\/www.frontiersin.org\/journals\/oncology\/articles\/10.3389\/fonc.2023.1273430\/full.","DOI":"10.3389\/fonc.2023.1273430"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Liou, H.H., Tsai, S.W., Hsieh, M.H.C., Chen, Y.J., Hsiao, J.R., Huang, C.C., Ou, C.-Y., Chang, C.-C., Lee, W.-T., and Tsai, S.-T. (2022). Evaluation of objective and subjective swallowing outcomes in patients with dysphagia treated for head and neck cancer. J. Clin. Med., 11.","DOI":"10.3390\/jcm11030692"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e5934","DOI":"10.17267\/2965-3738bis.2024.e5934","article-title":"Effects of transcranial direct current stimulation (tDCS) on speech and quality of life of a total glossectomy patient: A case report","volume":"3","author":"Pereira","year":"2024","journal-title":"Brain Imaging Stimul."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"192","DOI":"10.5507\/bp.2020.016","article-title":"Text-to-speech synthesis as an alternative communication means after total laryngectomy","volume":"165","author":"Repova","year":"2021","journal-title":"Biomed. Pap. Med. Fac. Palacky Univ. Olomouc"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1177\/0194599818765718","article-title":"The role of psychosocial factors on communicative participation in head and neck cancer survivors","volume":"159","author":"Eadie","year":"2018","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"2410","DOI":"10.1016\/j.pec.2022.02.007","article-title":"Silenced: Patients\u2019 experiences of voicelessness in head and neck cancer","volume":"105","author":"Gibson","year":"2022","journal-title":"Patient Educ. Couns."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1001\/jamaoto.2024.5254","article-title":"Current progress and future directions of immunotherapy in head and neck squamous cell carcinoma: A narrative review","volume":"151","author":"Sim","year":"2025","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1056\/NEJMoa2415434","article-title":"Neoadjuvant and adjuvant pembrolizumab in locally advanced head and neck cancer","volume":"393","author":"Uppaluri","year":"2025","journal-title":"N. Engl. J. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1001\/jamaoto.2025.0410","article-title":"Neoadjuvant therapy for mucosal head and neck squamous cell carcinoma: A review from the american head and neck society","volume":"151","author":"Contrera","year":"2025","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Payne, K., Pugh, M., Brooks, J., Batis, N., Taylor, G., Nankivell, P., and Mehanna, H. (2020). Circulating tumour cell expression of immune markers as prognostic and therapeutic biomarkers in head and neck squamous cell carcinoma: A systematic review and meta-analysis. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21218229"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"113854","DOI":"10.1016\/j.addr.2021.113854","article-title":"Lack of predictive tools for conventional and targeted cancer therapy: Barriers to biomarker development and clinical translation","volume":"176","author":"Batis","year":"2021","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Wang, D., Zeng, F., Zhang, S., Hu, W., Wang, Y., Ouyang, D., Zeng, B., Zeng, G., Li, J., and Liao, G. (2025). Pathological Regression Patterns Following Neoadjuvant Chemo-Immunotherapy in Head and Neck Squamous Cell Carcinoma: A Pilot Study. Front. Immunol., 16, Available online: https:\/\/www.frontiersin.org\/journals\/immunology\/articles\/10.3389\/fimmu.2025.1627442\/full.","DOI":"10.3389\/fimmu.2025.1627442"},{"key":"ref_78","first-page":"e18012","article-title":"Efficacy of neoadjuvant immunotherapy in head and neck squamous carcinoma (HNSCC): A systematic review and meta-analysis","volume":"43","author":"Laliotis","year":"2025","journal-title":"J. Clin. Oncol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e18112","DOI":"10.1200\/JCO.2025.43.16_suppl.e18112","article-title":"Managing the invisible: Treatment approaches after pathological complete response (pCR) to neoadjuvant chemotherapy in oral cancer","volume":"43","author":"Bhandarkar","year":"2025","journal-title":"J. Clin. Oncol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e002485","DOI":"10.1136\/jitc-2021-002485","article-title":"Neoadjuvant immunoradiotherapy results in high rate of complete pathological response and clinical to pathological downstaging in locally advanced head and neck squamous cell carcinoma","volume":"9","author":"Leidner","year":"2021","journal-title":"J. Immunother. Cancer"},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Rao, K.N., Sreeram, M.P., de Bree, R., Mendenhall, W.M., Strojan, P., Stenman, G., M\u00e4kitie, A., Nadal, A., Rodrigo, J.P., and Ng, S.P. (2025). The oncological outcome of postoperative radiotherapy in patients with node-negative early-stage (T1\/T2\/N0) oral squamous cell carcinoma and perineural invasion: A meta-analysis. Cancers, 17.","DOI":"10.3390\/cancers17050862"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1007\/s12325-024-02861-6","article-title":"Primary management of operable locally advanced oral cavity squamous cell carcinoma: Current concepts and strategies","volume":"41","author":"Asarkar","year":"2024","journal-title":"Adv. Ther."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/22\/2847\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T15:16:23Z","timestamp":1762787783000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/22\/2847"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,10]]},"references-count":83,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["diagnostics15222847"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15222847","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,10]]}}}