The value of routine follow-up after treatment for head and neck cancer. A national DAHANCA study

Anja Pagh, Thomas Vedtofte, Charlotte Duch Lynggaard, Niclas Rubek, Matilde Mia Nis-Hansen Lonka, Jørgen Johansen, Elo Andersen, Claus Andrup Kristensen, Christian von Buchwald, Maria Andersen, Christian Godballe, Jens Overgaard, Cai Grau

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Abstrakt

BACKGROUND: The post-treatment follow-up is well-integrated in the oncologic care tradition, based on the risk of developing recurrent disease or new primary tumors in treated patients. Furthermore, follow-up serves as an opportunity to monitor treatment effects and to provide clinical care of side effects. In this study we measured the activity and effectiveness of routine follow-up in head and neck cancer and assessed the value of follow-up from the perspectives of both physicians and the patients.

PATIENTS AND METHODS: During a period of six weeks a prospective national cross section cohort of 619 patients attending regular follow-up were enrolled. All patients had received intended curative treatment for head and neck cancer and all were followed according to DAHANCA guidelines. Data were collected by the physician filling in a registration form containing chosen key parameters and patients filling in a validated questionnaire.

RESULTS: The majority (91%) of the 619 visits was planned, and 75% of all visits included either tumor or treatment-related problems. Suspicion of recurrent disease led to further diagnostic work-up in 80 visits (13%). A total of 29 recurrences were found, and of these seven (25%) were asymptomatic, i.e. the "number needed to see" to detect one asymptomatic recurrence was 99. Treatment-related normal-tissue problems were addressed in 72% of all visits, and among these 18% required intervention. Although the majority of problems (either suspicion of recurrent disease or late effects) occurred within a few years after treatment, 39% of patients seen after three years also had problems. The majority of patients (97%) expressed satisfaction with the planned follow-up.

CONCLUSION: Only few relapses are found in asymptomatic patients at routine follow-up, with one silent recurrence detected per 99 visits. However, head and neck cancer survivors have a substantial need for management of sequelae. In this context, a centralized routine follow-up may still be worthwhile.

OriginalsprogEngelsk
Publikationsdato2013
Antal sider8
StatusUdgivet - 2013
BegivenhedPhD day 2013 - Aarhus, Danmark
Varighed: 11 jan. 201311 jan. 2013

Konference

KonferencePhD day 2013
LandDanmark
ByAarhus
Periode11/01/201311/01/2013

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  • Citationsformater

    Pagh, A., Vedtofte, T., Lynggaard, C. D., Rubek, N., Lonka, M. M. N-H., Johansen, J., Andersen, E., Kristensen, C. A., von Buchwald, C., Andersen, M., Godballe, C., Overgaard, J., & Grau, C. (2013). The value of routine follow-up after treatment for head and neck cancer. A national DAHANCA study. Abstract fra PhD day 2013, Aarhus, Danmark. http://phd.au.dk/fileadmin/grads.au.dk/HE/PhD_Day_2013_Abstract_Book_01.pdf