Current concepts of surveillance and its significance in head and neck cancer

Abstract

Follow-up in head and neck cancer (HNC) is essential to detect and manage locoregional recurrence or metastases, or second primary tumours at the earliest opportunity. A variety of guidelines and investigations have been published in the literature. This has led to oncologists using different guidelines across the globe. The follow-up protocols may have unnecessary investigations that may cause morbidity or discomfort to the patient and may have significant cost implications. In this evidencebased review we have tried to evaluate and address important issues like the frequency of follow-up visits, clinical and imaging strategies adopted, and biochemical methods used for the purpose. This review summarises strategies for follow-up, imaging modalities and key investigations in the literature published between 1980 and 2009. A set of recommendations is also presented for cost-effective, simple yet efficient surveillance in patients with head and neck cancer.

Incidence of second metachronous head and neck cancers: Population‐based outcomes over 25 years

“…The aim and basis of follow‐up in HNC is the early detection of potentially curable locoregional recurrence, second tumors, and report on any treatment sequelae affecting the quality of life in these patients . However, there is no consensus in the literature on the optimum frequency of follow‐up visits after treatment with curative intent . A recent national Canadian survey of radiation oncologists was conducted to understand their follow‐up practices.…”

LINE-1 and Alu Methylation Patterns in Lymph Node Metastases of Head and Neck Cancers

“…Metastasis from these cancers can be fatal (Manikantan, 2012). The 5-year survival rate is less than 50% for patients with a single unilateral lymph node metastasis and less than 25% for patients with bilateral metastases (Zhang, 2007).…”

Post-therapeutic Surveillance Schedule for Oral Cancer: Is There Agreement?

“…Some authors advocate routine CT imaging or plain chest X-ray [7,9,[22][23][24]. Other authors, however, advocate the use of chest X-ray only in symptomatic patients [1,3].…”

“…The authors recommended chest CT for high-risk patients, especially during the follow-up period [24]. Likewise, Manikantan et al [23] reviewed the literature and also recommended chest CT, instead of chest X-rays, for the detection of lung metastasis in patients who could be actively treated. Ultrasound is superior to the palpation for detection and classification of cervical lymph node metastasis and has the advantages of simplicity, its noninvasive nature, its lack of radiation exposure, and lower cost than CT, MRI, and FDG-PET [2,15,27,28]; Yuasa et al [2] evaluated the sonographic characteristics of metastatic cervical lymph nodes in an effort to identify adequate time intervals for follow-up sonography of the neck among tongue cancer patients.…”