Postradiotherapy surveillance practice for head and neck squamous cell carcinoma-too much for too little?

David L. Schwartz; Jerry Barker Jr; Kari Chansky; Bevan Yueh; Leila Raminfar; Pamela Drago; Christine Cha; Mary Austin-Seymour; George E. Laramore; Allen D. Hillel; Ernest A. Weymuller; Kent E. Wallner

doi:10.1002/hed.10314

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Postradiotherapy surveillance practice for head and neck squamous cell carcinoma-too much for too little?

Journal article

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Postradiotherapy surveillance practice for head and neck squamous cell carcinoma-too much for too little?

David L. Schwartz, Jerry Barker Jr, Kari Chansky, Bevan Yueh, Leila Raminfar, Pamela Drago, Christine Cha, Mary Austin-Seymour, George E. Laramore, Allen D. Hillel, …

Head & neck, Vol.25(12), pp.990-999

12/2003

DOI: 10.1002/hed.10314

PMID: 14648857

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Abstract

introduction. Limited information is available regarding surveillance patterns after head and neck cancer radiotherapy. We cataloged follow-up for a specified patient cohort treated at three neighboring university, community, and Veterans Administration institutions. Methods. One hundred fifteen patients were treated with curative intent between 1994–1998 with definitive or postoperative radiotherapy for newly diagnosed squamous cell carcinoma of the oral cavity, oropharynx, larynx, or hypopharynx. One hundred patients had continuous follow-up at their treating institution and were included for analysis. Median follow-up until disease recurrence or censorship was 28.5 months. Results. Median follow-up frequency was 5.7 visits/year and was highly variable. Although visit frequency correlated with disease stage and the presence of high-risk disease features, this association was lost when patients with early recurrences were removed from analysis. Procedure and test utilization closely mirrored visit frequency, resulting in a wide range of estimated yearly charges ($0–15,668/year; median, $1,772/year). Actuarial 3-year overall survival for the study group was 71%. Eighty-six percent (19 of 22) of potentially salvageable locoregional failures were discovered secondary to symptomatic complaint rather than by test results. Disease failure, whether detected by symptom or testing, predicted for poor survival (22% at 24 months after recurrence). Conclusions. Postradiotherapy surveillance for head and neck cancer is inconsistently pursued. A proven correlation between intensive follow-up and improved patient survival is lacking. Surveillance directed by patient symptoms should be investigated as an alternative approach.

Radiotherapy

cost analysis

follow-up

head and neck cancer

surveillance

Details

Title: Subtitle: Postradiotherapy surveillance practice for head and neck squamous cell carcinoma-too much for too little?
Creators: David L. Schwartz - ITER
Jerry Barker Jr - University of Washington
Kari Chansky - Fred Hutch Cancer Center
Bevan Yueh - Health Services Research & Development
Leila Raminfar - ITER
Pamela Drago - Virginia Mason Medical Center
Christine Cha - Virginia Mason Medical Center
Mary Austin-Seymour - University of Washington
George E. Laramore - University of Washington
Allen D. Hillel - University of Washington
Ernest A. Weymuller - University of Washington
Kent E. Wallner - University of Washington
Resource Type: Journal article
Publication Details: Head & neck, Vol.25(12), pp.990-999
DOI: 10.1002/hed.10314
PMID: 14648857
NLM abbreviation: Head Neck
ISSN: 1043-3074
eISSN: 1097-0347
Publisher: Wiley Subscription Services, Inc., A Wiley Company
Number of pages: 10
Language: English
Date published: 12/2003
Academic Unit: Otolaryngology
Record Identifier: 9984966751502771

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