Comparative effectiveness of posttreatment imaging modalities for Medicare patients with advanced head and neck cancer

Abstract

Background Persistent controversy exists with regard to how and when patients with head and neck cancer should undergo imaging after definitive therapy. The current study was conducted to evaluate whether the type of imaging modality used in posttreatment imaging impacts cancer‐specific survival for patients with advanced head and neck squamous cell carcinoma. Methods A retrospective study of National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program–Medicare‐linked data in patients with an advanced stage of the 3 most common head and neck malignancies (oral cavity, oropharynx, and larynx) was conducted. Hazard ratios and 95% CIs for cancer‐specific survival were estimated for patients diagnosed with any of these cancers between 2006 and 2015. Results Significant improvement with regard to cancer‐specific survival was observed among patients with American Joint Committee on Cancer stage III and stage IVA laryngeal cancer who underwent positron emission tomography (PET) and/or computed tomography (CT) imaging during the first 6 months after receipt of definitive treatment (hazard ratio, 0.517; 95% CI, 0.33‐0.811) compared with those who underwent CT. There was a trend toward an improvement in cancer‐specific survival among patients with oral cavity or oropharyngeal malignancies who underwent PET/CT imaging, but it did not reach statistical significance. Conclusions Compared with CT imaging, posttreatment imaging with PET was associated with improved survival in patients with advanced laryngeal carcinoma.

Evaluation of Optimal Assessment Schedules for Surveillance After Definitive Locoregional Treatment of Locally Advanced Head and Neck Cancer

“…Although several medical societies have made recommendations, these mainly depended on expert opinions rather than solid evidence. Furthermore, they did not consider the risk of HNC recurrence, which is greatly dependent on the primary subsite, tumor stage, and molecular markers, such as human papillomavirus (HPV) status . Therefore, assessment schedules are often determined arbitrarily by physicians in daily clinical practice, which produces heterogeneous and inconsistent plans .…”

“…Furthermore, they did not consider the risk of HNC recurrence, which is greatly dependent on the primary subsite, tumor stage, and molecular markers, such as human papillomavirus (HPV) status. 11 Therefore, assessment schedules are often determined arbitrarily by physicians in daily clinical practice, which produces heterogeneous and inconsistent plans. 9 This approach has been associated with over-and undersurveillance of tumor recurrence, thus imposing unnecessary economic and resource burdens on health care systems.…”

Long-Term Care and Follow-Up in Laryngeal Cancer Patients: A Multicenter Retrospective Analysis

“…Some authors reported incidences of lung SPTs among overall SPTs of up to 39% [ 29 , 30 ] which is similar to our data (29/91 patients or 32%). Among various surveillance imaging tools, FDG PET/CT proved to be the most sensitive [ 31 , 32 , 33 ]. According to some authors, a 12-month PET scan revealed tumor recurrence or SPT in 10% of cases [ 34 ].…”

AQP9 and ZAP70 as immune-related prognostic biomarkers suppress proliferation, migration and invasion of laryngeal cancer cells

“…Laryngeal cancer patients experience badly impaired vocal, respiratory, and swallowing functions with unfavorable prognoses [ 3 ]. The onset of laryngeal cancer is dormant and most of patients (~ 60%) present with advanced (stage III and IV) disease when diagnosed [ 4 ]. Tendency to local invasion and cervical lymph node metastases badly affect patients’ survival outcomes [ 5 ].…”