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Critical review of the follow-up protocol for head and neck cancer patients

Published online by Cambridge University Press:  22 April 2019

E Kytö ,
E Haapio ,
H Minn  and
H Irjala
E Kytö*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, University of Turku and Turku University Hospital, Finland
E Haapio
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, University of Turku and Turku University Hospital, Finland
H Minn
Affiliation:
Department of Oncology, University of Turku and Turku University Hospital, Finland
H Irjala
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, University of Turku and Turku University Hospital, Finland
*
Author for correspondence: Dr Eero Kytö, Department of Otorhinolaryngology – Head and Neck Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4–8, PL52 20521 Turku, Finland E-mail: eero.kyto@tyks.fi Fax: +358 231 3525
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Abstract

Objective

Head and neck cancer follow-up length, interval and content are controversial. Therefore, this study aimed to evaluate the efficacy of the follow-up protocol after curative treatment in head and neck cancer patients.

Method

Clinical data of 456 patients with new malignancy of the head and neck from a tertiary care centre district from 1999 to 2008 were analysed. Time from treatment, symptoms and second-line treatment outcomes of patients with recurrent disease were evaluated.

Results

A total of 94 (22 per cent) patients relapsed during the 5-year follow-up period; 90 per cent of recurrences were found within 3 years. Fifty-six per cent of the patients had subjective symptoms indicating a recurrence of the tumour. All recurrent tumours found during routine follow-up visits without symptoms were found within 34 months after completion of treatment.

Conclusion

Routine follow up after three years is questionable; recurrent disease beyond this point was detected in only 2 per cent of patients. In this study, all late tumour recurrences had symptoms of the disease. Easy access to extra follow-up visits when symptoms occur could cover the need for late follow up.

Keywords

Head And Neck CancerFollow-Up StudiesSurvivalRecurrence
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 5 , May 2019 , pp. 424 - 429
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr E Kytö takes responsibility for the integrity of the content of the paper

References

1Chaturvedi, AK, Anderson, WF, Lortet-Tieulent, J, Curado, MP, Ferlay, J, Franceschi, S et al. Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers. J Clin Oncol 2013;31:4550–9Google Scholar
2Argiris, A, Karamouzis, MV, Raben, D, Ferris, RL. Head and neck cancer. Lancet 2008;371:1695–709Google Scholar
3Leemans, CR, Braakhuis, BJ, Brakenhoff, RH. The molecular biology of head and neck cancer. Nat Rev Cancer 2011;11:9–22Google Scholar
4Paniello, RC, Virgo, KS, Johnson, MH, Clemente, MF, Johnson, FE. Practice patterns and clinical guidelines for posttreatment follow-up of head and neck cancers: a comparison of 2 professional societies. Arch Otolaryngol Head Neck Surg 1999;125:309–13Google Scholar
5Simo, R, Homer, J, Clarke, P, Mackenzie, K, Paleri, V, Pracy, P et al. Follow-up after treatment for head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130:S208–11Google Scholar
6Hussein, AA, Helder, MN, de Visscher, JG, Leemans, CR, Braakhuis, BJ, de Vet, HCW et al. Global incidence of oral and oropharynx cancer in patients younger than 45 years versus older patients: a systematic review. Eur J Cancer 2017;82:115–27Google Scholar
7Roman, BR, Goldenberg, D, Givi, B, Education Committee of American Head and Neck Society (AHNS). AHNS Series--Do you know your guidelines? Guideline recommended follow-up and surveillance of head and neck cancer survivors. Head Neck 2016;38:168–74Google Scholar
8Brennan, KE, Hall, SF, Owen, TE, Griffiths, RJ, Peng, Y. Variation in routine follow-up care after curative treatment for head-and-neck cancer: a population-based study in Ontario. Curr Oncol 2018;25:e120–31Google Scholar
9Denaro, N, Merlano, MC, Russi, EG. Follow-up in head and neck cancer: do more does it mean do better? A systematic review and our proposal based on our experience. Clin Exp Otorhinolaryngol 2016;9:287–97Google Scholar
10Gatta, G, Botta, L, Sánchez, MJ, Anderson, LA, Pierannunzio, D, Licitra, L et al. Prognoses and improvement for head and neck cancers diagnosed in Europe in early 2000s: the EUROCARE-5 population-based study. Eur J Cancer 2015;51:2130–43Google Scholar
11Flynn, CJ, Khaouam, N, Gardner, S, Higgins, K, Enepekides, D, Balogh, J et al. The value of periodic follow-up in the detection of recurrences after radical treatment in locally advanced head and neck cancer. Clin Oncol (R Coll Radiol) 2010;22:868–73Google Scholar
12de Visscher, AV, Manni, JJ. Routine long-term follow-up in patients treated with curative intent for squamous cell carcinoma of the larynx, pharynx, and oral cavity. Does it make sense? Arch Otolaryngol Head Neck Surg 1994;120:934–9Google Scholar
13Boysen, ME, Zätterström, UK, Evensen, JF. Self-reported symptoms to monitor recurrent head and neck cancer – analysis of 1,678 cases. Anticancer Res 2016;36:2849–54Google Scholar
14Ritoe, SC, de Vegt, F, Scheike, IM, Krabbe, PF, Kaanders, JH, van den Hoogen, FJ et al. Effect of routine follow-up after treatment for laryngeal cancer on life expectancy and mortality: results of a Markov model analysis. Cancer 2007;109:239–47Google Scholar
15Ritoe, SC, Krabbe, PF, Kaanders, JH, van den Hoogen, FJ, Verbeek, AL, Marres, HA. Value of routine follow-up for patients cured of laryngeal carcinoma. Cancer 2004;101:1382–9Google Scholar
16Liu, G, Dierks, EJ, Bell, RB, Bui, TG, Potter, BE. Post-therapeutic surveillance schedule for oral cancer: is there agreement? Oral Maxillofac Surg 2012;16:327–40Google Scholar
17Gilbert, R, Devries-Aboud, M, Winquist, E, Waldron, J, McQuestion, M, Head and Neck Cancer Disease Site Group. The Management of Head and Neck Cancer in Ontario. Toronto, ON: Cancer Care Ontario, 2009Google Scholar
18Mehanna, H, Wong, WL, Dunn, J. Management of advanced head and neck cancer. N Engl J Med 2016;375:492–3Google Scholar
19Basch, E, Deal, AM, Dueck, AC, Scher, HI, Kris, MG, Hudis, C et al. Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA 2017;318:197–8Google Scholar