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

2011 ◽  
Vol 93 (8) ◽  
pp. 576-582 ◽  
Author(s):  
Kapila Manikantan ◽  
Raghav C Dwivedi ◽  
Suhail I Sayed ◽  
KA Pathak ◽  
Rehan Kazi
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cost Effective ◽  
Second Primary ◽  
Evidence Based ◽  
Significant Cost ◽  
Second Primary Tumours ◽  
Cost Implications

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 evidence-based 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.

The future of radiotherapy and chemotherapy in head and neck cancer

2000 ◽  
Vol 114 (6) ◽  
pp. 411-413
Author(s):  
Caroline H. Bridgewater ◽  
Margaret F. Spittle
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Stage I ◽  
Second Primary ◽  
Accelerated Radiotherapy ◽  
Second Primary Tumours ◽  
The Future ◽  
Regional Disease

For the 40 per cent of patients with head and neck cancer who present with stage I and II disease either radiotherapy or surgery can be curative. The remaining 60 per cent have advanced loco-regional disease and even when treated with surgery and radiotherapy the five-year survival is less than 30 per cent. Most patients with relapse have loco-regional disease and second primary tumours have an incidence of three per cent a year.1 Current attempts to improve prognosis include the addition of chemotherapy, the use of brachytherapy and accelerated radiotherapy regimes such as continuous hyperfractionated accelerated radiotherapy (CHART).

scholarly journals Toxicity of Isotretinoin in a Chemoprevention Trial to Prevent Second Primary Tumours Following Head and Neck Cancer

1994 ◽  
Vol 86 (23) ◽  
pp. 1799-1801 ◽  
Author(s):  
S. E. BENNER ◽  
T. F. PAJAK ◽  
J. STETZ ◽  
S. M. LIPPMAN ◽  
W. K. HONG ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Second Primary ◽  
Second Primary Tumours ◽  
Chemoprevention Trial

scholarly journals Follow-up after treatment for head and neck cancer: United Kingdom National Multidisciplinary Guidelines

2016 ◽  
Vol 130 (S2) ◽  
pp. S208-S211 ◽  
Author(s):  
R Simo ◽  
J Homer ◽  
P Clarke ◽  
K Mackenzie ◽  
V Paleri ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Narrow Band Imaging ◽  
Evidence Base ◽  
Second Primary ◽  
Allied Health Professionals ◽  
Lateral Skull Base ◽  
The Uk

AbstractThis is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. In the absence of high-level evidence base for follow-up practices, the duration and frequency are often at the discretion of local centres. By reviewing the existing literature and collating experience from varying practices across the UK, this paper provides recommendations on the work up and management of lateral skull base cancer based on the existing evidence base for this rare condition.Recommendations• Patients should be followed up to a minimum of five years with a prolonged follow-up for selected patients. (G)• Patients should be followed up at least two monthly in the first two years and three to six monthly in the subsequent years. (G)• Patients should be seen in dedicated multidisciplinary head and neck oncology clinics. (G)• Patients should be followed up by dedicated multidisciplinary clinical teams. (G)• The multidisciplinary follow-up team should include clinical nurse specialists, speech and language therapists, dietitians and other allied health professionals in the role of key workers. (G)• Clinical assessment should include adequate clinical examination including fibre-optic rigid or flexible nasopharyngolaryngoscopy. (R)• Magnetic resonance imaging and positron emission tomography combined with computed tomography imaging should be used when recurrence is suspected. (R)• Narrow band imaging can be used in the follow-up in selected sites. (R)• Second primary tumours should be part of rationale of follow-up and therefore adequate screening strategies should be used to detect them. (G)• Patients should be educated with regard to the appearance and detection of recurrences. (G)• Patients with persistent pain should be investigated to exclude recurrent disease. (R)• Patients should be offered support with tobacco and alcohol cessation services. (R)

scholarly journals Submandibular gland flap in reconstruction of head and neck cancer defects

2020 ◽  
Vol 6 (12) ◽  
pp. 2267
Author(s):  
Viresh Arora ◽  
Bhushan Kathuria ◽  
Madhuri Arora
Keyword(s):  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Submandibular Gland ◽  
Neck Cancer ◽  
Oral Cavity Cancer ◽  
Wound Dehiscence ◽  
Free Flaps ◽  
Second Primary

<p class="abstract">Management of head and neck cancer defects has been challenging owing to the complexity of the created defects. Various local and regional flaps to free flaps have been described in the reconstruction of cancer defects, each of them having it’s own merits and limitations, therefore none of them appears as an ideal one. A Submandibular gland flap (SMGF) technique has emerged as a versatile flap having advantages of a regional and a free flap. In this study, eleven patients (four tongue, six buccal mucosa defects and one retromolar trigone defect) underwent reconstruction of oral cavity cancer defects with SMGF. The outcomes of the SMGF were evaluated in terms of the ease of harvest, functional outcome, and postoperative complications. The mean defect size and the flap dimensions were 4.4×3.9 cm and 3.6×3.3 cm respectively. One patient suffered wound infection resulting in partial flap necrosis with wound dehiscence. In the follow-up period one patient developed contra nodal recurrence and another patient developed a second primary on the contralateral base of the tongue. This study showed that SMGF is an excellent flap for the reconstruction of oral cavity cancer defects because of its reliability, versatility and its relative ease of application.</p>

Risk stratified follow up for head and neck cancer patients – An evidence based proposal

Oral Oncology ◽  
2021 ◽  
Vol 119 ◽  
pp. 105365
Author(s):  
Francesca De Felice ◽  
Mary Lei ◽  
Richard Oakley ◽  
Andrew Lyons ◽  
Alastair Fry ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Evidence Based

Can head and neck cancer patients be discharged after three years?

2013 ◽  
Vol 127 (10) ◽  
pp. 991-996 ◽  
Author(s):  
R Kumar ◽  
G Putnam ◽  
P Dyson ◽  
A K Robson
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Second Primary ◽  
Recurrence Rates ◽  
Time To Recurrence ◽  
History Of ◽  
The Uk

AbstractBackground:Follow-up surveillance of head and neck cancer patients varies throughout the UK. The heterogeneity of these patients limits the applicability of a standardised protocol. Improvements in our understanding of the natural history of the disease may assist in the tailoring of resources to patients.Method:Prospective data collected at the Cumberland Infirmary over a 13-year period were analysed, primarily focusing upon recurrence rates and time to recurrence.Results:In keeping with other studies, recurrence of head and neck squamous cell carcinoma was found to be maximal within the first three years of treatment, regardless of subsite.Conclusion:Hospital-based surveillance may be safely discontinued after three years for some patients. Laryngeal carcinoma may require further surveillance due to possible delayed recurrence of a second primary formation. Emphasis must be placed on patient education, accessibility to head and neck services, and the existence of a robust system to facilitate urgent referrals.

Surveillance of Patients with Head and Neck Cancer with an Intensive Clinical and Radiologic Follow-up

2019 ◽  
Vol 161 (4) ◽  
pp. 635-642 ◽  
Author(s):  
Martina Imbimbo ◽  
Salvatore Alfieri ◽  
Laura Botta ◽  
Cristiana Bergamini ◽  
Annunziata Gloghini ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Care Center ◽  
Tertiary Care ◽  
Cancer Recurrence ◽  
Second Primary ◽  
Upper Aerodigestive Tract ◽  
Second Primary Cancers

Objective There is no consensus on the follow-up modalities in patients with head and neck cancer. This study aims to describe the pattern and survival outcomes of recurrences/second primary cancers in patients undergoing an intensive radiologic and clinical follow-up. Study Design Retrospective analysis. Setting Single academic tertiary care center. Subjects and Methods All patients with stage III-IV head and neck cancer treated with chemoradiotherapy at our institution between 1998 and 2010 were retrospectively reviewed. Persistent/recurrent disease within 6 months since the curative treatment and second primary cancers outside the upper aerodigestive tract were excluded. Data were analyzed by descriptive statistics. Surveillance was planned every 3 months in the first year, then with increasing intervals till the fifth year. Results A total of 326 patients were included. Out of all detected cancer recurrences (n = 106, 32%), 38 (36%) were locoregional, 44 (41%) were distant, and 24 (23%) were second primary cancers. Approximately 70% of recurrences were clinically and/or radiologically discovered, while 30% were diagnosed due to the patients’ symptoms. Of all clinically and/or radiologically discovered recurrences/second primary cancers (n = 74), 26 (35%) were curatively treated, with respect to 9 of the 32 (28%) diagnosed by symptoms. Median overall survival of recurrent curable cases did not significantly differ according to the detection modality (89 months by clinical/radiologic examination vs 85 by symptoms). Conclusions Clinical and radiologic follow-up identified more recurrences/second primary cancers than the symptom-driven monitoring, but the curability of cancer recurrence was similar regardless of detection modality. Prospective trials are needed to define the most effective follow-up strategy in head and neck cancer.

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