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Article Citation - WoS: 122Citation - Scopus: 140European White Paper: Oropharyngeal Dysphagia in Head and Neck Cancer(Springer, 2021) Baijens, Laura W. J.; Walshe, Margaret; Aaltonen, Leena-Maija; Arens, Christoph; Cordier, Reinie; Cras, Patrick; Clave, PerePurpose To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. Methods Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. Results Twenty-four sections on HNC-specific OD topics. Conclusion This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.Article Transoral Robotic Surgery (TORS) for Head and Neck Cancer in the Elderly Population: Functional Outcomes, Survival, and Complications(Wiley, 2025) Pamuk, Erim; Beharry, Avinash; Lambercy, Karma; Dalla-Vale, Margaux; Wahler, Nina; Hosal, Sefik; Simon, ChristianObjective: To compare functional and oncologic outcomes in elderly (>= 70 years) and nonelderly (< 70 years) patients after transoral robotic surgery (TORS). Methods: A retrospective chart review was conducted on 114 patients who underwent TORS for head and neck squamous cell carcinoma between 2012 and 2022. Patient and tumor characteristics, perioperative details, complications, and survival parameters were analyzed. Swallowing function was assessed using the Functional Outcome Swallowing Scale (FOSS). Results: Of the 114 patients, 37 (32.5%) were elderly, and 77 (67.5%) were nonelderly. Elderly patients had higher comorbidity scores (p < 0.001). Oropharyngeal and oral cavity primaries were more common in the nonelderly group, whereas laryngeal primaries predominated in elderly patients (p < 0.01). Complication rates were higher in nonelderly (37.6%) than in elderly (18.9%) patients, though not statistically significant (p = 0.07). In elderly patients, FOSS scores showed no significant change preoperatively, postoperatively (< 3 months), or at the last follow-up (median 36 months). The nonelderly group experienced worse early postoperative FOSS scores compared to baseline but showed significant improvement, returning to preoperative levels by the last follow-up. Nonelderly patients had better FOSS scores at last follow-up compared to elderly patients (p = 0.014). Overall and recurrence-free survival outcomes were better in the nonelderly group, but disease-specific survival rates were comparable. Conclusion: Despite higher comorbidity rates in the elderly, TORS demonstrated favorable complication rates in the elderly population. Swallowing function returned to baseline after 3 months in both groups. TORS appears safe for elderly patients with comparable oncologic outcomes.
