Martina Imbimbo1, Salvatore Alfieri1, Laura Botta2, Cristiana Bergamini1, Annunziata Gloghini3, Giuseppina Calareso4, Ester Orlandi5, Nicola Alessandro Iacovelli5, Marco Guzzo6, Roberta Granata1, Carlo Resteghini1, Laura Locati1, Chiara Costanza Volpi3, Lisa Licitra1,7, Paolo Bossi1. 1. Head and Neck Cancer Medical Oncology 3 Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 2. Evaluative Epidemiology, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 3. Diagnostic Pathology and Laboratory Medicine Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 4. Radiology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 5. Radiotherapy Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 6. Head and Neck Surgery Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 7. University of Milan, Milan, Italy.
Abstract
OBJECTIVE: 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. STUDY DESIGN: Retrospective analysis. SETTING: Single academic tertiary care center. SUBJECTS AND METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
OBJECTIVE: 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. STUDY DESIGN: Retrospective analysis. SETTING: Single academic tertiary care center. SUBJECTS AND METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Entities:
Keywords:
follow-up; head and neck cancer; recurrence; secondary primary cancer; surveillance
Authors: John M Hoyle; Tanya A Correya; Kelly Kenzik; Liton Francisco; Sharon A Spencer; Christopher D Willey; James A Bonner; James W Snider; Drexell Hunter Boggs; William R Carroll; Smita Bhatia; Andrew M McDonald Journal: Head Neck Date: 2022-01-25 Impact factor: 3.147
Authors: Petr Szturz; Carl Van Laer; Christian Simon; Dirk Van Gestel; Jean Bourhis; Jan B Vermorken Journal: Front Oncol Date: 2020-05-06 Impact factor: 6.244
Authors: Vivek Nair; Samuel Auger; Sara Kochanny; Frederick M Howard; Daniel Ginat; Olga Pasternak-Wise; Aditya Juloori; Matthew Koshy; Evgeny Izumchenko; Nishant Agrawal; Ari Rosenberg; Everett E Vokes; M Reza Skandari; Alexander T Pearson Journal: JAMA Netw Open Date: 2022-04-01