Post-therapeutic surveillance strategies in head and neck squamous cell carcinoma

Antoine Digonnet, Marc Hamoir, Guy Andry, Missak Haigentz, Robert P. Takes, Carl E. Silver, Dana M. Hartl, Primož Strojan, Alessandra Rinaldo, Remco De Bree, Andreas Dietz, Vincent Grégoire, Vinidh Paleri, Johannes A. Langendijk, Vincent Vander Poorten, Michael L. Hinni, Juan P. Rodrigo, Carlos Suárez, William M. Mendenhall, Jochen A. WernerEric M. Genden, Alfio Ferlito

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

The management of head and neck squamous cell carcinomas does not end with the completion of ablative therapy. The oncologic objectives of post-treatment follow-up are to detect recurrences and second primary tumors; beyond that, follow-up should evaluate acute and chronic treatment-related side effects, guide the rehabilitation process, alleviate functional loss, manage pain, restore nutritional status and assess psychosocial factors. In this structured review, we address the questions of timing and the tools required to achieve a complete and coherent routine surveillance. Several guidelines and consensus statements recommend clinical examination as the cornerstone of follow-up which should be performed for at least 5 years, although there are no data in favor of any one particular follow-up program, and only low-level evidence suggests an improvement in oncologic outcomes by close follow-up. Baseline imaging (computed tomography and magnetic resonance imaging) should be obtained within 2-6 months after definitive therapy if used for treatment response evaluation. Metabolic response, if indicated, should be assessed preferably after 3 months in patients who undergo curative-intent therapy with (chemo)-radiotherapy. Chest computed tomography is more sensitive than plain radiography, if used in follow-up, but the benefit and cost-effectiveness of routine chest computed tomography has not been demonstrated. There are no current data supporting modifications specific to the surveillance plan of patients with human papillomavirus-associated disease.

Original languageEnglish (US)
Pages (from-to)1569-1580
Number of pages12
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume270
Issue number5
DOIs
StatePublished - May 2013

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Keywords

  • Distant metastasis
  • Head and neck cancer
  • HPV
  • Recurrence
  • Surveillance strategy

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Digonnet, A., Hamoir, M., Andry, G., Haigentz, M., Takes, R. P., Silver, C. E., Hartl, D. M., Strojan, P., Rinaldo, A., De Bree, R., Dietz, A., Grégoire, V., Paleri, V., Langendijk, J. A., Vander Poorten, V., Hinni, M. L., Rodrigo, J. P., Suárez, C., Mendenhall, W. M., ... Ferlito, A. (2013). Post-therapeutic surveillance strategies in head and neck squamous cell carcinoma. European Archives of Oto-Rhino-Laryngology, 270(5), 1569-1580. https://doi.org/10.1007/s00405-012-2172-7