The Impact of Compliance in Posttreatment Surveillance in Head and Neck Squamous Cell Carcinoma

Deutschmann, Michael W.; Sykes, Kevin J.; Harbison, John W.; Cabrera‐Muffly, Cristina; Shnayder, Yelizaveta

doi:10.1001/jamaoto.2015.0643

Cited by 21 publications

(19 citation statements)

References 11 publications

(6 reference statements)

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“…Our study employed the surveillance schedule as outlined by the NCCN HNC guidelines. Deutschmann et al investigated an institutional surveillance schedule and the impact of adherence with that schedule on survival, which demonstrated findings similar to those in our study. The proportion of patients adherent with surveillance was found to be 49%, similar to the 50.2% in our study.…”

Section: Discussionsupporting

confidence: 90%

“…In this study, living >100 miles from the treatment center resulted in three times higher odds of nonadherence with surveillance. Distance was also associated with adherence with treatment in the study by Deutschmann et al Poor treatment adherence has been demonstrated in other studies due to distance traveled for care . However, treatment at centers with higher facility and surgeon volumes have been demonstrated to result in improved overall outcomes .…”

Section: Discussionmentioning

confidence: 73%

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Adherence with National Comprehensive Cancer Network posttreatment surveillance guidelines in patients with head and neck cancer

et al. 2019

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Background Surveillance in head and neck cancer (HNC) is essential to detect recurrent or new lesions and to optimize function. This study describes drivers of surveillance adherence in patients with HNC and its effect on prognosis. Methods Adherence with surveillance of HNC patients was determined using the National Comprehensive Cancer Network HNC guidelines. Logistic regression and Cox proportional hazards models were used to determine predictors of adherence and overall survival (OS). Results Results showed that 110 of 221 patients (50.2%) were adherent with surveillance. Distance from the treatment center was the only significant association. Adherence was not associated with OS following multivariate adjustment (adjusted hazard ratio [aHR] = 0.68, 95% confidence interval [CI] = 0.43‐1.09). However, 5‐10 years after treatment completion, adherence was an independent predictor of survival (aHR = 0.24, 95% CI = 0.09‐0.61). Conclusion Adherence with surveillance is important in improving survival in patients with HNC, especially in the long term.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 73%

Adherence with National Comprehensive Cancer Network posttreatment surveillance guidelines in patients with head and neck cancer

et al. 2019

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“…However, in these instances there is a concern that many at‐risk patients may not have received disciplined and periodic surveillance, increasing the risk of undetected nodal recurrence. A 2015 retrospective cohort study examining the effects of compliance with post‐treatment surveillance on overall survival noted a 30% noncompliance rate over the study period and decreased overall survival when >3 appointments were missed . In addition, the functional postoperative outcome with salvage treatment may be increasingly morbid, with possible secondary hospitalization, longer recovery time, and more extensive surgery.…”

Section: Discussionmentioning

confidence: 99%

Elective neck dissection (END) and cN0 hard palate and upper gingival cancers: A National Cancer Database analysis of factors predictive of END and impact on survival

Obayemi

Cracchiolo

Migliacci

et al. 2019

Journal of Surgical Oncology

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Background and Objectives: The reported risk of nodal metastasis in hard palate and upper gingival squamous cell carcinoma (SCC) has been inconsistent with inadequate consensus regarding the utility of neck dissection in the clinically negative (cN0) neck. Materials and Methods: Using the National Cancer Database, cN0 patients diagnosed with SCC of the head and neck with the subsites of the hard palate and upper gingiva were identified from 2004 to 2014. Results: A total of 1830 patients were identified, and END was performed on 422 patients with cN0 tumors. Pathologically positive nodes occurred in 14% (59/422) of patients in this cohort. Higher tumor stage, academic hospital type, and large hospital volume (>28 cancer-specific cases/year) were associated with a higher likelihood of END both in univariate and multivariate analyses (P < .05). Patients >80 years of age were less likely to receive END on multivariate analysis (OR 0.52, 0.32-0.84). No variables, including advanced T stage, predicted occult metastases. Cox proportional hazards regression analysis showed that patients who underwent END demonstrated improved OS over an 11-year period (hazard ratio 0.75, P = .002). On subgroup analysis, this improvement was significant in patients with both stage T1 and T4 tumors.Conclusions: Tumor stage, hospital type, and hospital volume were associated with higher rates of END for patients with cN0 hard palate SCC and after controlling for clinical factors, END was associated with improved overall survival. K E Y W O R D S carcinoma squamous cell head and neck, gingiva, hard palate, logistic models, neck dissection, prevalence How to cite this article: Obayemi A Jr, Cracchiolo JR, Migliacci JC, et al. Elective neck dissection (END) and cN0 hard palate and upper gingival cancers: A National Cancer Database analysis of factors predictive of END and impact on survival.

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“…Because these patients rarely completely recover function, the complex medical needs persist throughout the remainder of the patient's lifetime, and require the commitment of the patient, family, and his/her many health care providers. The limited studies evaluating patient adherence with this demanding posttreatment regimen suggest that adherence may be a challenge, with between 30% and 50% of patients not adhering to recommended follow‐up appointments …”

Section: Introductionmentioning

confidence: 99%

“…The limited studies evaluating patient adherence with this demanding posttreatment regimen suggest that adherence may be a challenge, with between 30% and 50% of patients not adhering to recommended follow-up appointments. 11,12 There have been many studies evaluating quality of life in patients with oral/oropharyngeal cancer. Studies suggest that patients diagnosed with these cancers have a compromised quality of life compared to the general population.…”

Section: Introductionmentioning

confidence: 99%

Survivorship care experiences, information, and support needs of patients with oral and oropharyngeal cancer

et al. 2016

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Background There is little research documenting the post-treatment experiences and needs of oral/oropharyngeal cancer survivors. Methods In this cross-sectional study, 92 patients diagnosed with oral/oropharyngeal cancer diagnosed between 2 and 5 years prior completed a survey about oral cancer information and support needs. Results About half retrospectively reported that they did not receive a written treatment summary. The desire for more oral cancer information was common: One-third or more desired more information about long-term effects, recommended follow-up, and symptoms that should prompt contacting a doctor. Support needs were less common: Only a lack of energy was rated as a significant support need. Patients who had a recurrence, did not drink alcohol, and had a greater recurrence fear desired more information. Smokers and more distressed patients reported more support needs. Conclusions Survivors reported the desire for more oral cancer information. A desire for assistance was less common.

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The Impact of Compliance in Posttreatment Surveillance in Head and Neck Squamous Cell Carcinoma

Abstract: Patients with head and neck squamous cell carcinoma were significantly more likely to survive with completion of follow-up and tobacco cessation. Compliance with PTS was associated with smoking cessation and traveling less than 200 miles for follow-up.

Cited by 21 publications

References 11 publications

Adherence with National Comprehensive Cancer Network posttreatment surveillance guidelines in patients with head and neck cancer

Adherence with National Comprehensive Cancer Network posttreatment surveillance guidelines in patients with head and neck cancer

Elective neck dissection (END) and cN0 hard palate and upper gingival cancers: A National Cancer Database analysis of factors predictive of END and impact on survival

Survivorship care experiences, information, and support needs of patients with oral and oropharyngeal cancer

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