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      European white paper: oropharyngeal dysphagia in head and neck cancer

      research-article
      1 , 2 , , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 14 , 19 , 20 , 21 , 3 , 22 , 23 , 24 , 17 , 1 , 25 , 3 , 26 , 27 , 28 , 6 , 7 , 29 , 30 , 31 , 32 , 33 , 2 , 28 , 34 , 35 , 36 , 37
      European Archives of Oto-Rhino-Laryngology
      Springer Berlin Heidelberg
      Head and neck cancer, Dysphagia, White paper, Deglutition, Swallowing

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Purpose

          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.

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          Most cited references445

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          The Hospital Anxiety and Depression Scale

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            The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging.

            The American Joint Committee on Cancer (AJCC) staging manual has become the benchmark for classifying patients with cancer, defining prognosis, and determining the best treatment approaches. Many view the primary role of the tumor, lymph node, metastasis (TNM) system as that of a standardized classification system for evaluating cancer at a population level in terms of the extent of disease, both at initial presentation and after surgical treatment, and the overall impact of improvements in cancer treatment. The rapid evolution of knowledge in cancer biology and the discovery and validation of biologic factors that predict cancer outcome and response to treatment with better accuracy have led some cancer experts to question the utility of a TNM-based approach in clinical care at an individualized patient level. In the Eighth Edition of the AJCC Cancer Staging Manual, the goal of including relevant, nonanatomic (including molecular) factors has been foremost, although changes are made only when there is strong evidence for inclusion. The editorial board viewed this iteration as a proactive effort to continue to build the important bridge from a "population-based" to a more "personalized" approach to patient classification, one that forms the conceptual framework and foundation of cancer staging in the era of precision molecular oncology. The AJCC promulgates best staging practices through each new edition in an effort to provide cancer care providers with a powerful, knowledge-based resource for the battle against cancer. In this commentary, the authors highlight the overall organizational and structural changes as well as "what's new" in the Eighth Edition. It is hoped that this information will provide the reader with a better understanding of the rationale behind the aggregate proposed changes and the exciting developments in the upcoming edition. CA Cancer J Clin 2017;67:93-99. © 2017 American Cancer Society.
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              Definition and classification of cancer cachexia: an international consensus.

              To develop a framework for the definition and classification of cancer cachexia a panel of experts participated in a formal consensus process, including focus groups and two Delphi rounds. Cancer cachexia was defined as a multifactorial syndrome defined by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment. Its pathophysiology is characterised by a negative protein and energy balance driven by a variable combination of reduced food intake and abnormal metabolism. The agreed diagnostic criterion for cachexia was weight loss greater than 5%, or weight loss greater than 2% in individuals already showing depletion according to current bodyweight and height (body-mass index [BMI] <20 kg/m(2)) or skeletal muscle mass (sarcopenia). An agreement was made that the cachexia syndrome can develop progressively through various stages--precachexia to cachexia to refractory cachexia. Severity can be classified according to degree of depletion of energy stores and body protein (BMI) in combination with degree of ongoing weight loss. Assessment for classification and clinical management should include the following domains: anorexia or reduced food intake, catabolic drive, muscle mass and strength, functional and psychosocial impairment. Consensus exists on a framework for the definition and classification of cancer cachexia. After validation, this should aid clinical trial design, development of practice guidelines, and, eventually, routine clinical management. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                laura.baijens@mumc.nl
                Journal
                Eur Arch Otorhinolaryngol
                Eur Arch Otorhinolaryngol
                European Archives of Oto-Rhino-Laryngology
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0937-4477
                1434-4726
                19 December 2020
                19 December 2020
                2021
                : 278
                : 2
                : 577-616
                Affiliations
                [1 ]GRID grid.412966.e, ISNI 0000 0004 0480 1382, Department of Otorhinolaryngology, Head and Neck Surgery, , Maastricht University Medical Center, ; Maastricht, The Netherlands
                [2 ]GRID grid.412966.e, ISNI 0000 0004 0480 1382, GROW School for Oncology and Developmental Biology, , Maastricht University Medical Center, ; Maastricht, The Netherlands
                [3 ]GRID grid.8217.c, ISNI 0000 0004 1936 9705, Department of Clinical Speech and Language Studies, , Trinity College Dublin, ; Dublin, Ireland
                [4 ]Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
                [5 ]Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Magdeburg, Otto-von-Guericke University, Magdeburg, Germany
                [6 ]GRID grid.5510.1, ISNI 0000 0004 1936 8921, Department of Special Needs Education, , University of Oslo, ; Oslo, Norway
                [7 ]GRID grid.1032.0, ISNI 0000 0004 0375 4078, School of Occupational Therapy, Social Work and Speech Pathology, , Curtin University, ; Perth, Australia
                [8 ]Department of Neurology, Born Bunge Institute, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
                [9 ]GRID grid.414106.6, ISNI 0000 0000 8642 9959, Voice, Speech, Swallowing Lab, Department of Otorhinolaryngology, Head and Neck Surgery, , University Hospital UVSQ and Research lab CNRS-UMR7018, Hôpital Foch, ; Suresnes, France
                [10 ]Swallows Head and Neck Cancer Charity, Blackpool, UK
                [11 ]GRID grid.22254.33, ISNI 0000 0001 2205 0971, Department of Head and Neck Surgery, , The Greater Poland Cancer Centre, Poznan University of Medical Sciences, ; Poznan, Poland
                [12 ]GRID grid.439749.4, ISNI 0000 0004 0612 2754, Head and Neck Cancer Centre, , University College London Hospital, ; London, UK
                [13 ]GRID grid.154185.c, ISNI 0000 0004 0512 597X, Department of Experimental Clinical Oncology, , Aarhus University Hospital, ; Aarhus, Denmark
                [14 ]GRID grid.6190.e, ISNI 0000 0000 8580 3777, Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, , University of Cologne, ; Cologne, Germany
                [15 ]GRID grid.412940.a, ISNI 0000 0004 0455 6778, Robert White Centre for Airway, Voice and Swallow, , Poole Hospital NHS Foundation Trust, ; Dorset, UK
                [16 ]Deutsche Stimmklinik, Hamburg, Germany
                [17 ]GRID grid.13648.38, ISNI 0000 0001 2180 3484, Departement of Voice, Speech and Hearing Disorders, , University Medical Center Hamburg-Eppendorf, ; Hamburg, Germany
                [18 ]GRID grid.440424.2, ISNI 0000 0004 0595 4604, Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, , Atılım University, Medicana International Ankara, ; Ankara, Turkey
                [19 ]GRID grid.12380.38, ISNI 0000 0004 1754 9227, Department of Otolaryngology, Head and Neck Surgery, , Amsterdam University Medical Centres, Vrije Universiteit, ; Amsterdam, The Netherlands
                [20 ]GRID grid.12380.38, ISNI 0000 0004 1754 9227, Cancer Center Amsterdam, , Amsterdam University Medical Centres, Vrije Universiteit, ; Amsterdam, The Netherlands
                [21 ]GRID grid.8217.c, ISNI 0000 0004 1936 9705, Division of Restorative Dentistry and Periodontology, Faculty of Health Sciences, , Trinity College Dublin, Dublin Dental University Hospital, ; Dublin, Ireland
                [22 ]GRID grid.41724.34, Department of Otorhinolaryngology, Head and Neck Surgery, , Rouen University Hospital, ; Rouen, France
                [23 ]GRID grid.5491.9, ISNI 0000 0004 1936 9297, Department of Ear Nose and Throat Surgery, , The Robert White Centre for Airway Voice and Swallowing, Poole Hospital NHS Foundation Trust, University of Southampton, ; Southampton, UK
                [24 ]GRID grid.416409.e, ISNI 0000 0004 0617 8280, Department of Speech and Language Therapy, , St. James’s Hospital, ; Dublin, Ireland
                [25 ]GRID grid.412966.e, ISNI 0000 0004 0480 1382, MHeNs School for Mental Health and Neuroscience, , Maastricht University Medical Center, ; Maastricht, The Netherlands
                [26 ]GRID grid.5596.f, ISNI 0000 0001 0668 7884, Department Neurosciences, Experimental Otorhinolaryngology, Deglutology, , University of Leuven, ; Leuven, Belgium
                [27 ]GRID grid.4708.b, ISNI 0000 0004 1757 2822, Department of Biomedical and Clinical Sciences “L. Sacco”, , University of Milan, ; Milan, Italy
                [28 ]GRID grid.412966.e, ISNI 0000 0004 0480 1382, Department of Respiratory Medicine, , NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, ; Maastricht, The Netherlands
                [29 ]GRID grid.10419.3d, ISNI 0000000089452978, Department of Otorhinolaryngology and Head and Neck Surgery, , Leiden University Medical Centre, ; Leiden, The Netherlands
                [30 ]Faculty of Health, School of Health and Social Development, Victoria, Australia
                [31 ]GRID grid.419555.9, ISNI 0000 0004 1759 7675, Head and Neck Oncology Service, , Candiolo Cancer Institute, FPO - IRCCS, ; Candiolo, TO Italy
                [32 ]GRID grid.7605.4, ISNI 0000 0001 2336 6580, Department of Oncology, , University of Turin, ; Orbassano, TO Italy
                [33 ]GRID grid.5254.6, ISNI 0000 0001 0674 042X, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, , University of Copenhagen, ; Copenhagen, Denmark
                [34 ]GRID grid.412966.e, ISNI 0000 0004 0480 1382, Division of Medical Oncology, Department of Internal Medicine, , Maastricht University Medical Center, ; Maastricht, The Netherlands
                [35 ]GRID grid.14442.37, ISNI 0000 0001 2342 7339, Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, , Hacettepe University, ; Ankara, Turkey
                [36 ]GRID grid.7080.f, Gastrointestinal Physiology Laboratory, Hospital de Mataró, , Universitat Autònoma de Barcelona, ; Mataró, Spain
                [37 ]GRID grid.452371.6, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), ; Barcelona, Spain
                Author information
                http://orcid.org/0000-0003-1406-6425
                Article
                6507
                10.1007/s00405-020-06507-5
                7826315
                33341909
                472ff2bc-b4c3-4a7a-8997-8b51f4f09d1e
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 27 February 2020
                : 17 November 2020
                Funding
                Funded by: Maastricht University Medical Center (UMC+)
                Categories
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                © Springer-Verlag GmbH Germany, part of Springer Nature 2021

                Otolaryngology
                head and neck cancer,dysphagia,white paper,deglutition,swallowing
                Otolaryngology
                head and neck cancer, dysphagia, white paper, deglutition, swallowing

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