Post-therapeutic surveillance strategies in head and neck squamous cell carcinoma |
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Authors: | Antoine Digonnet Marc Hamoir Guy Andry Missak Haigentz Jr Robert P Takes Carl E Silver Dana M Hartl Primož Strojan Alessandra Rinaldo Remco de Bree Andreas Dietz Vincent Grégoire Vinidh Paleri Johannes A Langendijk Vincent Vander Poorten Michael L Hinni Juan P Rodrigo Carlos Suárez William M Mendenhall Jochen A Werner Eric M Genden Alfio Ferlito |
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Institution: | 1. Department of Head and Neck and Thoracic Surgery, Institut Jules Bordet, Brussels, Belgium 2. Department of Head and Neck Surgery, Cancer Center, St. Luc University Hospital, Brussels, Belgium 3. Division of Oncology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA 4. Department of Otolaryngology-Head and Neck Surgery, Nijmegen Medical Center, Radboud University, Nijmegen, The Netherlands 5. Departments of Surgery and Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA 6. Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France 7. Laboratoire de Phonétique et de Phonologie, Sorbonne Nouvelle, Paris, France 8. Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia 9. ENT Clinic, University of Udine, Piazzale S. Maria della Misericordia, 33100, Udine, Italy 10. Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands 11. Department of Otorhinolaryngology, University of Leipzig, Leipzig, Germany 12. Radiation Oncology Department and Center for Molecular Imaging and Experimental Radiotherapy, Université Catholique de Louvain, St-Luc University Hospital, Brussels, Belgium 13. Department of Otolaryngology-Head and Neck Surgery, Newcastle upon Tyne Foundation Hospitals NHS Trust, Newcastle upon Tyne, UK 14. Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands 15. Department of Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium 16. Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, AZ, USA 17. Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain 18. Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain 19. Department of Radiation Oncology, University of Florida, Gainesville, FL, USA 20. Department of Otolaryngology-Head and Neck Surgery, Philipp University, Marburg, Germany 21. Department of Otolaryngology-Head and Neck Surgery, The Mount Sinai Medical Center, New York, NY, USA
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Abstract: | The management of head and neck squamous cell carcinomas does not end with the completion of ablative therapy. The oncologic objectives of post-treatment follow-up are to detect recurrences and second primary tumors; beyond that, follow-up should evaluate acute and chronic treatment-related side effects, guide the rehabilitation process, alleviate functional loss, manage pain, restore nutritional status and assess psychosocial factors. In this structured review, we address the questions of timing and the tools required to achieve a complete and coherent routine surveillance. Several guidelines and consensus statements recommend clinical examination as the cornerstone of follow-up which should be performed for at least 5 years, although there are no data in favor of any one particular follow-up program, and only low-level evidence suggests an improvement in oncologic outcomes by close follow-up. Baseline imaging (computed tomography and magnetic resonance imaging) should be obtained within 2–6 months after definitive therapy if used for treatment response evaluation. Metabolic response, if indicated, should be assessed preferably after 3 months in patients who undergo curative-intent therapy with (chemo)-radiotherapy. Chest computed tomography is more sensitive than plain radiography, if used in follow-up, but the benefit and cost-effectiveness of routine chest computed tomography has not been demonstrated. There are no current data supporting modifications specific to the surveillance plan of patients with human papillomavirus-associated disease. |
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