Patient-reported swallowing function after treatment for early-stage oropharyngeal carcinoma: Population-based study

Background: Single-modality treatment (surgery or radiotherapy [RT]) is a curative treatment option for early-stage oropharyngeal carcinoma (OPC) with comparable (excellent) oncological outcomes. This study aimed to compare self-reported swallowing function. Methods: Participants with a T1-2N0-2bM0 OPC who were offered single-modality treatment and were recruited to the Head and Neck 5000 study were included. Prospectively collected self-reported swallowing function was compared between surgery and RT. Results: Those offered RT (n = 150) had less favorable baseline characteristics than those offered surgery (n = 150). At 12-month follow up, RT participants reported more swallowing problems (35% vs 23%, RR 1.3; 95% CI 0.8-2.3, P =.277) in models adjusted for baseline characteristics. In those allocated to surgery who received adjuvant therapy (n = 78, 52%), the proportion with swallowing problems was similar to those allocated to RT alone. Conclusions: Participants offered surgery alone had similar mortality but improved swallowing, although this was not statistically significant. However, over half of participants offered surgery alone received surgery and adjuvant therapy.