Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of a post-treatment follow-up program in patients with oral squamous cell carcinoma

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

The duration and the frequency of follow-up after treatment of oral squamous cell carcinoma are not standardized in the current literature. The purpose of this study was to evaluate our local standard post-treatment and follow-up protocol.

Materials and methods

Overall, 228 patients treated curatively from 01/2006 to 07/2013 were reviewed. To evaluate the follow-up program, data on the secondary event were used. To determine risk groups, all patients with tumor recurrence were specifically analyzed. Relapse-free rate were estimated by the Kaplan-Meier product limit method. The chi-square test was used to identify independent risk factors for tumor relapse.

Results

In total, 29.8 % patients had a secondary event. The majority of the relapse cases (88.2 %) were detected within 2 years postoperatively, 61.8 % of them within the first year. Most events were local recurrences (34.7 %). UICC-stage IV was significantly associated with tumor recurrence (p = 0.001). Gender (p = 0.188), age (p = 0.195), localization (p = 0.739), T-stage (p = 0.35), N-stage (p = 0.55), histologic grade (p = 0.162), and tobacco and alcohol use (p = 0.248) were not significantly associated with tumor recurrence. Patients with positive neck nodes relapsed earlier (p = 0.011). The majority of relapses (86.3 %) were found in asymptomatic patients at routine follow-up.

Conclusions

The results of this study suggest an intensified follow-up within the first 2 years after surgery.

Clinical relevance

Given the higher relapse rate of patients exhibiting an UICC-stage IV and/or positive neck nodes, it seems to be from special interest to perform in this group a risk-adapted follow-up with monthly examinations also in the second year.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig 1

Similar content being viewed by others

References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61(2):69–90. doi:10.3322/caac.20107

    Article  PubMed  Google Scholar 

  2. Shah JP, Gil Z (2009) Current concepts in management of oral cancer—surgery. Oral Oncol 45(4–5):394–401. doi:10.1016/j.oraloncology.2008.05.017

    Article  PubMed  Google Scholar 

  3. Camisasca DR, Silami MA, Honorato J, Dias FL, de Faria PA, Lourenço Sde Q (2011) Oral squamous cell carcinoma clinicopathological features in patients with and without recurrence. ORL J Otorhinolaryngol Relat Spec 73(3):170–176. doi:10.1159/000328340

    Article  PubMed  Google Scholar 

  4. Ebrahimi A, Clark JR, Zhang WJ, Elliott MS, Gao K, Milross CG, Shannon KF (2011) Lymph node ratio as an independent prognostic factor in oral squamous cell carcinoma. Head Neck 33(9):1245–1251. doi:10.1002/hed.21600

    Article  PubMed  Google Scholar 

  5. Boysen M (1994) Value of follow-up in patients treated for squamous cell carcinomas of the oral cavity and oropharynx. Recent Results Canc Res 134:205–214

    Article  Google Scholar 

  6. Merkx MA, van Gulick JJ, Marres HA, Kaanders JH, Bruaset I, Verbeek A, de Wilde PC (2006) Effectiveness of routine follow-up of patients treated for T1–2 N0 oral squamous cell carcinomas of the floor of mouth and tongue. Head Neck 28(1):1–7

    Article  PubMed  Google Scholar 

  7. Wensing BM, Merkx MA, Krabbe PF, Marres HA, Van den Hoogen FJ (2011) Oral squamous cell carcinoma and a clinically negative neck: the value of follow-up. Head Neck 33(10):1400–1405. doi:10.1002/hed.21642

    Article  PubMed  Google Scholar 

  8. de Visscher AV, Manni JJ (1994) Routine long-term follow-up in patients treated with curative intent for squamous cell carcinoma of the larynx, pharynx, and oral cavity: does it make sense? Arch Otolaryngol Head Neck Surg 120(9):934–939

    Article  PubMed  Google Scholar 

  9. Rivelli V, Luebbers HT, Weber FE, Cordella C, Graetz KW, Kruse AL (2011) Screening recurrence and lymph node metastases in head and neck cancer: the role of computer tomography in follow-up. Head Neck Oncol 3:18. doi:10.1186/1758-3284-3-18

    Article  PubMed  PubMed Central  Google Scholar 

  10. Wittekind C, Meyer HJ (2010) TNM: Klassifikation maligner Tumoren, 7. Auflage. Wiley-VCH, Weinheim

    Google Scholar 

  11. Gilbert R, Devries-Aboud M, Winquist E, Waldron J, McQuestion M (2009) The management of head and neck cancer in Ontario. Evidence-Based Series 5–3. Toronto, ON: Cancer Care Ontario. https://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=58592. Accessed 19 May 2015

  12. Yuasa K, Kawazu T, Kunitake N, Uehara S, Omagari J, Yoshiura K, Nakayama E, Kanda S (2000) Sonography for the detection of cervical lymph node metastases among patients with tongue cancer: criteria for early detection and assessment of follow-up examination intervals. Am J Neuroradiol 21(6):1127–1132

    PubMed  Google Scholar 

  13. Wolff KD, Follmann M, Nast A (2012) The diagnosis and treatment of oral cavity cancer. Dtsch Arztebl Int 109(48):829–835. doi:10.3238/arztebl.2012.0829

    PubMed  PubMed Central  Google Scholar 

  14. National Comprehensive Cancer Network (2014) Guidelines Head and Neck Cancers. Version 2.2014. http://entcancercare.com/pdf/for_dr/NCCN%202014%20head-and-neck.pdf. Accessed 10 May 2015

  15. British Association of Head and Neck Oncologists (2001) Practice care guidance for clinicians participating in the management of head and neck cancer patients in the UK. Drawn up by a Consensus Group of Practising Clinicians. Eur J Surg Oncol 27:1–17

    Article  Google Scholar 

  16. Overgaard J, Hansen HS, Specht L et al (2003) Five compared with six fractions per week of conventional radiotherapy of squamous-cell carcinoma of head and neck: DAHANCA 6 and 7 randomised controlled trial. Lancet 362(9388):933–940

    Article  PubMed  Google Scholar 

  17. Flynn CJ, Khaouam N, Gardner S et al (2010) The value of periodic follow-up in the detection of recurrences after radical treatment in locally advanced head and neck cancer. Clin Oncol 22(10):868–873. doi:10.1016/j.clon.2010.05.016

    Article  Google Scholar 

  18. Ritoe SC, Krabbe PF, Kaanders JH, van den Hoogen FJ, Verbeek AL, Marres HA (2004) Value of routine follow-up for patients cured of laryngeal carcinoma. Cancer 101(6):1382–1389

    Article  PubMed  Google Scholar 

  19. Saussez S, Dekeyser C, Thill MP, Chantrain G (2007) Importance of clinical and radiological follow-up in head and neck cancers. B-ENT 3(4):179–184

    PubMed  Google Scholar 

  20. Grau JJ, Cuchi A, Traserra J, Fírvida JL, Arias C, Blanch JL, Estapé J (1997) Follow-up study in head and neck cancer: cure rate according to tumor location and stage. Oncology 54(1):38–42

    Article  PubMed  Google Scholar 

  21. De Felice F, Musio D, Tombolini V (2015) Follow-up in head and neck cancer: a management dilemma. Adv Otolaryngol 703450:4. doi:10.1155/2015/703450

    Google Scholar 

  22. Hermans R (2008) Posttreatment imaging in head and neck cancer. Eur J Radiol 66(3):501–511

    Article  PubMed  Google Scholar 

  23. Anzai Y, Carroll WR, Quint DJ, Bradford CR, Minoshima S, Wolf GT, Wahl RL (1996) Recurrence of head and neck cancer after surgery or irradiation: prospective comparison of 2-deoxy-2-[F-18]fluoro-D-glucose PET and MR imaging diagnoses. Radiology 200(1):135–141

    Article  PubMed  Google Scholar 

  24. Schlumpf MF, Haerle S (2014) The current role of imaging in head and neck cancer: a clinician’s perspective. Swiss Med Wkly 144:w14015. doi:10.4414/smw.2014.14015

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cranio-Maxillofacial & Plastic Surgery, Jena University Hospital, Erlanger Allee 101, 07749, Jena, Germany

    Andre Peisker, Gregor Franziskus Raschke, Korosh Roshanghias & Stefan Schultze-Mosgau

  2. Department of Surgical Sciences, Marquette University, School of Dentistry, Milwaukee, Wisconsin, 53201-1881, USA

    Arndt Guentsch & Paul Luepke

Authors
  1. Andre Peisker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gregor Franziskus Raschke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Arndt Guentsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paul Luepke
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Korosh Roshanghias
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Stefan Schultze-Mosgau
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andre Peisker.

Ethics declarations

Conflict of interest

The authors declare that that they have no conflict of interest.

Funding source

No funding was secured for this study.

Ethical approval

Ethical standards were considered when performing the presented study. All patients gave written consent to the evaluation of their records. Prior to starting the presented study, we asked the local ethics committee of the Medical Faculty of the University Jena for approval. We were informed that ethical approval is not required as the presented study bases on routinely performed and retrospectively evaluated medical records.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Peisker, A., Raschke, G.F., Guentsch, A. et al. Evaluation of a post-treatment follow-up program in patients with oral squamous cell carcinoma. Clin Oral Invest 21, 135–141 (2017). https://doi.org/10.1007/s00784-016-1764-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-016-1764-9

Keywords

Search

Navigation