R Kumar1, G Putnam, P Dyson, A K Robson. 1. Department of Otolaryngology-Head and Neck Surgery, Cumberland Infirmary, Carlisle, UK.
Abstract
BACKGROUND: Follow-up surveillance of head and neck cancer patients varies throughout the UK. The heterogeneity of these patients limits the applicability of a standardised protocol. Improvements in our understanding of the natural history of the disease may assist in the tailoring of resources to patients. METHOD: Prospective data collected at the Cumberland Infirmary over a 13-year period were analysed, primarily focusing upon recurrence rates and time to recurrence. RESULTS: In keeping with other studies, recurrence of head and neck squamous cell carcinoma was found to be maximal within the first three years of treatment, regardless of subsite. CONCLUSION: Hospital-based surveillance may be safely discontinued after three years for some patients. Laryngeal carcinoma may require further surveillance due to possible delayed recurrence of a second primary formation. Emphasis must be placed on patient education, accessibility to head and neck services, and the existence of a robust system to facilitate urgent referrals.
BACKGROUND: Follow-up surveillance of head and neck cancerpatients varies throughout the UK. The heterogeneity of these patients limits the applicability of a standardised protocol. Improvements in our understanding of the natural history of the disease may assist in the tailoring of resources to patients. METHOD: Prospective data collected at the Cumberland Infirmary over a 13-year period were analysed, primarily focusing upon recurrence rates and time to recurrence. RESULTS: In keeping with other studies, recurrence of head and neck squamous cell carcinoma was found to be maximal within the first three years of treatment, regardless of subsite. CONCLUSION: Hospital-based surveillance may be safely discontinued after three years for some patients. Laryngeal carcinoma may require further surveillance due to possible delayed recurrence of a second primary formation. Emphasis must be placed on patient education, accessibility to head and neck services, and the existence of a robust system to facilitate urgent referrals.
Authors: Iain L Hutchison; Fran Ridout; Sharon M Y Cheung; Allan Hackshaw; Neil Shah; Peter Hardee; Christian Surwald; Janavikulam Thiruchelvam; Leo Cheng; Tim K Mellor; Peter A Brennan; Andrew J Baldwin; Richard J Shaw; Wayne Halfpenny; Martin Danford; Simon Whitley; Graham Smith; Malcolm W Bailey; Bob Woodwards; Manu Patel; Joseph McManners; Chi-Hwa Chan; Andrew Burns; Prav Praveen; Andrew C Camilleri; Chris Avery; Graham Putnam; Keith Jones; Keith Webster; William P Smith; Colin Edge; Iain McVicar; Nick Grew; Stuart Hislop; Nicholas Kalavrezos; Ian C Martin Journal: Br J Cancer Date: 2019-10-15 Impact factor: 7.640