Changes in patterns of care over the past ten years have resulted in the treatment of many oral and oropharyngeal cancer patients with primary radiotherapy plus/minus chemotherapy who would have previously received surgical intervention. It is expected that a number of these patients will present with recurrent or residual disease for which surgery will be required for cancer control. These patients may face significant functional impairment in speech and swallow functions after secondary or """"""""salvage"""""""" surgery. This study will examine the functional impairments and recovery of function experienced by this patient group over a 12 month period after surgical intervention. Functional status also will be compared with that of head and neck cancer patients treated with surgery and with that of patients treated with primary radiotherapy plus/minus chemotherapy. Accruals will include 50 patients with planned anterior oral cavity resections (e.g., oral tongue, anterior or lateral floor of mouth) and 50 patients with planned posterior oral cavity resections (e.g., tongue base, tonsil, lateral pharyngeal wall). This study is designed to: 1) determine the degree of impairment in speech and swallowing function in oral or oropharyngeal cancer patients with recurrent or residual disease after primary treatment with radiotherapy plus/minus chemotherapy who have been treated surgically; and determine how speech and swallowing function, and employment, socialization, and eating status change over time 1, 3, 6, and 12 months after surgery as compared to presurgical function; 2) determine the relative contributions of prior radiotherapy plus/minus chemotherapy and current surgical intervention to the degree of impairment of speech and swallow functions; determine whether the time to recurrence impacts on postsurgical speech and swallowing function; determine whether there are functional differences between patients with recurrent versus residual disease both before and after surgery; 3) compare the speech and swallowing function of surgically-treated oral or oropharyngeal cancer patients with recurrent or residual disease with that of patients with similar resections/reconstructions who have had surgery or surgery with post- operative radiotherapy only; 4) compare the speech and swallowing function of surgically-treated oral or oropharyngeal cancer patients with recurrent or residual disease with that of patients with similar cancers who receive radiotherapy plus/minus chemotherapy. Achievement of these objectives will identify the functional deficits and degree of severity experienced by surgically-treated oral or oropharyngeal cancer patients with recurrent or residual disease after primary treatment with radiotherapy plus/minus chemotherapy, and provide information on the relative functional status of patients treated with various modalities.
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