Ultrasound in patients with treated head and neck carcinomas

Abstract

Correct follow-up is necessary to avoid under- or overtreatment in the care of patients with treated carcinomas of head and neck. Ultrasound is a cost-effective, harmless, easy, and feasible method. It can be applied in the outpatient clinic in follow-up but the United Kingdom National Multidisciplinary guidelines are recommended computed tomography or magnetic resonance imaging for the detection of metastasis for head and neck carcinomas in the follow-up period. The purpose of the study was to state that neck ultrasound would be the method of choice on follow-up care of Chinese patients who received primary treatment for carcinoma of head and neck. Patients who received primary treatment for carcinoma of the head and neck were examined for 5-years in follow-up through physical, clinical, and neck ultrasound (n = 198). If patients had no evidence of disease after 60 months of definitive therapy considered as a cure. If patients had no evidence of disease after 36 months of salvage therapy considered as a cure of recurrence. Irrespective of definitive treatment used, the study was monitored through neck ultrasound during 5 years of a follow-up visit and was reported cure in 126 (64%) patients and recurrence in 72 (36%; distant metastasis: 33 [17%], local recurrence: 24 [12%], and regional recurrence: 15 [7%]) patients. Primary tumor stage IV, III, II, and I had 63% (15/24), 51% (21/41), 32% (18/56), and 23% (18/77) recurrence, respectively. The time to detect regional recurrence was shorter than that for local recurrence ( P < .0001, q = 15.059) and distant recurrence ( P < .0001, q = 7.958). Local recurrence and stage I primary tumor had the highest percentage cure for recurrence. Neck ultrasound in the follow-up period is reported to be effective for the detection of recurrence of patients who received primary treatment for carcinoma of head and neck especially regional recurrence and primary tumor stage I. Level of Evidence: III.

The Applications and Potential Developments of Ultrasound in Oral Cancer Management

“…Neck US is reported to be effective in the posttreatment surveillance. 34,55 Lin et al 32 have displayed a short-axis diameter, S/L ratio (shape), heterogeneous internal echo, and irregular margin are practical US parameters in determining recurrent LNs in the treated neck. Our research group has revealed that RT had an influence on ultrasonographic features in treated oral cancer patients.…”

“…28,29 In the treated neck of oral cancer patients, it is practical in early identifying a persistent nodal disease or cervical LN recurrence and in directing the need for salvage neck dissection. [30][31][32][33][34][35] Consequently, US can help the management of oral cancer in different scenarios. In this study, we aim to review the utility of US in oral cancer management in different phases (Table 1).…”

Ultrasound Is Beneficial to Determine Lymphadenopathy in Oral Cancer Patients after Radiotherapy

“…The regional recurrence rate of oral cancers following treatment ranges from 11% to 51.1% [4][5][6], and malignant lymphadenopathy mostly occurs within 2 years [6]. Clinically, we often depend on various types of imaging studies, such as ultrasound (US), magnetic resonance imaging (MRI), and computed tomography (CT), to detect possible nodal recurrence after the treatment of oral cancer [7][8][9]. For patients with advanced head and neck cancers after complete treatment, the guidelines of the 2022 National Comprehensive Cancer Network suggest various imaging methods, including US, MRI, CT, and positron emission tomography (PET), each having their own advantages during the surveillance period [10].…”