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Surveillance of Patients with Head and Neck Cancer with an Intensive Clinical and Radiologic Follow‐up
- Source :
- Otolaryngology–Head and Neck Surgery. 161:635-642
- Publication Year :
- 2019
- Publisher :
- Wiley, 2019.
-
Abstract
- There is no consensus on the follow-up modalities in patients with head and neck cancer. This study aims to describe the pattern and survival outcomes of recurrences/second primary cancers in patients undergoing an intensive radiologic and clinical follow-up.Retrospective analysis.Single academic tertiary care center.All patients with stage III-IV head and neck cancer treated with chemoradiotherapy at our institution between 1998 and 2010 were retrospectively reviewed. Persistent/recurrent disease within 6 months since the curative treatment and second primary cancers outside the upper aerodigestive tract were excluded. Data were analyzed by descriptive statistics. Surveillance was planned every 3 months in the first year, then with increasing intervals till the fifth year.A total of 326 patients were included. Out of all detected cancer recurrences (n = 106, 32%), 38 (36%) were locoregional, 44 (41%) were distant, and 24 (23%) were second primary cancers. Approximately 70% of recurrences were clinically and/or radiologically discovered, while 30% were diagnosed due to the patients' symptoms. Of all clinically and/or radiologically discovered recurrences/second primary cancers (n = 74), 26 (35%) were curatively treated, with respect to 9 of the 32 (28%) diagnosed by symptoms. Median overall survival of recurrent curable cases did not significantly differ according to the detection modality (89 months by clinical/radiologic examination vs 85 by symptoms).Clinical and radiologic follow-up identified more recurrences/second primary cancers than the symptom-driven monitoring, but the curability of cancer recurrence was similar regardless of detection modality. Prospective trials are needed to define the most effective follow-up strategy in head and neck cancer.
- Subjects :
- Male
secondary primary cancer
Aftercare
0302 clinical medicine
Neoplasms
follow-up
80 and over
Medicine
Tomography
Aged, 80 and over
Academic Medical Centers
0303 health sciences
Neoplasms, Second Primary
Middle Aged
Combined Modality Therapy
Magnetic Resonance Imaging
X-Ray Computed
Second Primary
Local
Head and Neck Neoplasms
Population Surveillance
030220 oncology & carcinogenesis
surveillance
Female
Radiology
Adult
medicine.medical_specialty
recurrence
Second Primary Cancers
Young Adult
03 medical and health sciences
head and neck cancer
Aged
Humans
Neoplasm Recurrence, Local
Positron-Emission Tomography
Retrospective Studies
Salvage Therapy
Survival Analysis
Tomography, X-Ray Computed
In patient
030304 developmental biology
Modalities
business.industry
Head and neck cancer
medicine.disease
Neoplasm Recurrence
Otorhinolaryngology
Surgery
business
Subjects
Details
- ISSN :
- 10976817 and 01945998
- Volume :
- 161
- Database :
- OpenAIRE
- Journal :
- Otolaryngology–Head and Neck Surgery
- Accession number :
- edsair.doi.dedup.....23ea12190d18703db7a0cfa57c4d5f4d