No abstract

No abstract

No abstract

The case mix was representative of all head and neck tumor sites and stages. Suspicion of recurrence was noted in 10% (nϭ96/951) of patients seen routinely. This rose to 68% (nϭ60/88) for the subset of patients who had requested an appointment. Most recurrences were found within the first follow-up year. Only 0.3% (nϭ3/1039) of asymptomatic patients attending routine appointments were suspected of having a recurrence, of whom 2 (0.2%) were found to have an actual recurrence following investigation. Of the total number of patients reporting a new symptom, recurrence was suspected in 56% (nϭ152/270). Patients thus had 98.1% sensitivity to raising suspicion for a recurrence based on the reporting of new symptoms with a 99.6% negative predictive value. CONCLUSION: Our data shows that the efficiency of the current system of routine follow-ups at detecting suspected recurrence of head and neck cancer is 10%, suggesting the need for a customized, more focused follow-up regime, tailored to individual cases. Patient education and close relationships with clinicians and allied health-care professionals are essential for early diagnosis and management of cancer recurrence. Follow-up within the first year should be most intensive as recurrence is most likely within this time, and it serves to alleviate patient anxiety in the early post-treatment period.