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

David Schwartz, Jerry Barker, 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

Research output: Contribution to journalArticle

51 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)990-999
Number of pages10
JournalHead and Neck
Volume25
Issue number12
DOIs
StatePublished - Dec 1 2003

Fingerprint

Head and Neck Neoplasms
Recurrence
Survival
Radiotherapy
Hypopharynx
United States Department of Veterans Affairs
Oropharynx
Larynx
Mouth
Carcinoma, squamous cell of head and neck
Squamous Cell Carcinoma

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

Cite this

Postradiotherapy surveillance practice for head and neck squamous cell carcinoma - Too much for too little? / Schwartz, David; Barker, Jerry; Chansky, Kari; Yueh, Bevan; Raminfar, Leila; Drago, Pamela; Cha, Christine; Austin-Seymour, Mary; Laramore, George E.; Hillel, Allen D.; Weymuller, Ernest A.; Wallner, Kent E.

In: Head and Neck, Vol. 25, No. 12, 01.12.2003, p. 990-999.

Research output: Contribution to journalArticle

Schwartz, D, Barker, J, Chansky, K, Yueh, B, Raminfar, L, Drago, P, Cha, C, Austin-Seymour, M, Laramore, GE, Hillel, AD, Weymuller, EA & Wallner, KE 2003, 'Postradiotherapy surveillance practice for head and neck squamous cell carcinoma - Too much for too little?', Head and Neck, vol. 25, no. 12, pp. 990-999. https://doi.org/10.1002/hed.10314
Schwartz, David ; Barker, Jerry ; Chansky, Kari ; Yueh, Bevan ; Raminfar, Leila ; Drago, Pamela ; Cha, Christine ; Austin-Seymour, Mary ; Laramore, George E. ; Hillel, Allen D. ; Weymuller, Ernest A. ; Wallner, Kent E. / Postradiotherapy surveillance practice for head and neck squamous cell carcinoma - Too much for too little?. In: Head and Neck. 2003 ; Vol. 25, No. 12. pp. 990-999.
@article{35d7d4f8987240c1a8916accd2e65ac5,
title = "Postradiotherapy surveillance practice for head and neck squamous cell carcinoma - Too much for too little?",
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.",
author = "David Schwartz and Jerry Barker and Kari Chansky and Bevan Yueh and Leila Raminfar and Pamela Drago and Christine Cha and Mary Austin-Seymour and Laramore, {George E.} and Hillel, {Allen D.} and Weymuller, {Ernest A.} and Wallner, {Kent E.}",
year = "2003",
month = "12",
day = "1",
doi = "10.1002/hed.10314",
language = "English (US)",
volume = "25",
pages = "990--999",
journal = "Head and Neck",
issn = "1043-3074",
publisher = "John Wiley and Sons Inc.",
number = "12",

}

TY - JOUR

T1 - Postradiotherapy surveillance practice for head and neck squamous cell carcinoma - Too much for too little?

AU - Schwartz, David

AU - Barker, Jerry

AU - Chansky, Kari

AU - Yueh, Bevan

AU - Raminfar, Leila

AU - Drago, Pamela

AU - Cha, Christine

AU - Austin-Seymour, Mary

AU - Laramore, George E.

AU - Hillel, Allen D.

AU - Weymuller, Ernest A.

AU - Wallner, Kent E.

PY - 2003/12/1

Y1 - 2003/12/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=10744229851&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10744229851&partnerID=8YFLogxK

U2 - 10.1002/hed.10314

DO - 10.1002/hed.10314

M3 - Article

C2 - 14648857

AN - SCOPUS:10744229851

VL - 25

SP - 990

EP - 999

JO - Head and Neck

JF - Head and Neck

SN - 1043-3074

IS - 12

ER -