Value of patient-reported symptoms in the follow up of patients potentially cured of laryngeal carcinoma

Abstract

ObjectiveTo evaluate the significance of patients’ ability to recognise symptoms that signify recurrence.MethodsA retrospective analysis was conducted in Norway of demographic, clinical and follow-up data for patients with laryngeal carcinoma considered free of disease following treatment. The study included clinical data from 732 patients with glottic tumours and 249 patients with supraglottic tumours who were considered cured of disease. Data on the site, time and type of recurrence (symptomatic or asymptomatic) were retrieved.ResultsRecurrence was observed in 127 patients with glottic tumours and 71 with supraglottic tumours. A total of 103 glottic recurrences and 53 supraglottic recurrences were symptomatic. For patients with glottic carcinoma, recurrence detection through symptoms was associated with a favourable post-salvage survival rate compared with asymptomatic recurrences (p = 0.003).ConclusionA patient's ability to self-detect ‘red flag’ symptoms and self-initiate visits represents a previously ignored prognostic factor, and may rationalise follow up and improve survival.

T1 glottic laryngeal cancer: the role of routine follow-up visits in detecting local recurrence

“…In their study, 122 of 156 (78%) LSCC recurrences and second primary tumors were found within 3 year follow-up, and 94 of 156 (60%) recurrences and second primary tumors were detected on a routine follow-up visit [ 11 ]. In another study, 81% (103 of 127) of patients with stage I to IV glottic LSCC who developed a recurrence were symptomatic [ 12 ]. In our study of T1 patients, the number of symptomatic patients was substantially lower.…”

Case study of the integration of electronic patient‐reported outcomes as standard of care in a head and neck oncology practice: Obstacles and opportunities

“…In our ePROs program, we opted to administer multiple longitudinal surveys anchored with a clinical visit. Multiple surveys allowed for the analysis of the trajectory of treatment‐related side effects 4 and monitoring for recurrence 8‐10 . Incorporating survey delivery into a visit also improved adoption in the follow‐up setting (Fig.…”

Recurrence of laryngeal squamous cell carcinoma in patients undergoing organ preservation therapy: are there symptoms associated with recurrence?

“…Several recent studies have shown that most recurrences of head and neck malignant neoplasms are detected through symptoms reported by patients, instead of physical examination of asymptomatic patients during follow-up 12 . Boysen et al 12:1-7 found "[…] a higher rate of symptomatic versus asymptomatic recurrences in glottic and supraglottic recurrences, particularly in the first two years of follow-up".…”