Value of routine follow‐up for patients cured of laryngeal carcinoma

Abstract

BACKGROUND Routine follow‐up offered to patients with laryngeal carcinoma in The Netherlands consisted of 22 routine visits over a time period of 10 years after treatment. The primary aims of the follow‐up were to detect cancer recurrence in asymptomatic patients and to achieve better survival outcome by reducing cancer‐specific mortality rates. METHODS A longitudinal cohort study was performed to evaluate the effect of this follow‐up schedule. Between January 1990 and January 1995, the authors studied all patients with primary laryngeal squamous cell carcinoma who were treated with intention to cure. For patients who developed cancer recurrence, all routine and extra visits were documented. Reported symptoms and physical evidence of tumor were mapped. RESULTS The patients complied with the follow‐up protocol closely. In only 2% of all routine visits an asymptomatic cancer recurrence was found. There was no difference in survival and tumor mortality rates for patients with and without symptoms, despite the difference in whether the therapy applied had the intention to cure. It seemed that patients who developed tumor recurrence after therapy for laryngeal carcinoma received no benefit from screening for cancer recurrence detection. The lack of benefit for cancer detection screening among asymptomatic patients might be explained by unfavorable tumor biology parameters. CONCLUSIONS The routine follow‐up program after treatment for laryngeal carcinoma did not lead to survival benefit for asymptomatic patients with tumor recurrence. Cancer 2004. © 2004 American Cancer Society.

Addition of 18F-FDG PET/CT to Clinical Assessment Predicts Overall Survival in HNSCC: A Retrospective Analysis with Follow-up for 12 Years

“…About 50%-70% of patients with head and neck squamous cell carcinoma (HNSCC) achieve a complete response, with residual or recurrent disease being detected in 30%-50% of cases either at the primary site or in the neck (6). Approximately 80% of tumor recurrence in HNSCC occurs during the first 2 y after treatment (7).…”

Evaluation of laryngeal cancer cases treated at our clinic from 2000 to 2005

“…Laryngeal cancers account for approximately 2% of all cancers (2.3% in males and 0.4% in females) (1) . All of our 40 study patients were male, perhaps because more males than females smoke in our country.…”

“…11 in terms of all male cancers worldwide. The disease is most common in males aged 50-70 years and is rare in those aged <20 years (1) .…”

“…Surgery, radiotherapy, and chemotherapy are delivered individually or in combination. It is difficult to define the most appropriate treatment, the choice of which should be based on tumor location; the extents of tumor spread and differentiation; metastasis status; patient age, occupation, social position, and general health status; the morbidity and mortality associated with treatment; and the treatment success rate (1) . Therefore, we retrospectively reviewed the epidemiology, preoperative indications, treatment modalities, complications, tumor histopathology, prognosis, and outcomes of 40 patients treated for laryngeal cancer.…”

Variation in Routine Follow-Up Care After Curative Treatment for Head-and-Neck Cancer: A Population-Based Study in Ontario

“…Research into follow-up strategies for head-and-neck cancer has not shown an advantage in overall survival with routine cancer surveillance for timely detection of recurrence [5][6][7][8][9][10] , and no randomized clinical trials have compared follow-up strategies with no follow-up 11 . The literature pertaining to how follow-up care can most effectively manage morbidity and address other health needs in head-and-neck cancer patients is limited 12,13 .…”