Significance of self-reported symptoms as part of follow-up routines in patients treated for oral squamous cell carcinoma

Anticancer Res. 2014 Nov;34(11):6593-9.

Abstract

Background: There is little evidence to prove that frequent out-patient consultations lead to better prognosis in patients treated for oral squamous cell carcinoma. Furthermore, there is no consensus regarding the timing and number of follow-up consultations or the duration of monitoring after completed therapy.

Materials and methods: We prospectively recorded demographic and clinical data of 537 patients treated over a period of 15 years with complete follow-up of 18 years in a tertiary academic Center.

Results: Out of 537 patients considered free of disease after treatment, 196 (36%) developed recurrent disease during follow-up. Self-reported symptoms led to diagnosis of the recurrence in 78% of the cases. Only 22% of recurrences were detected through physical examination of asymptomatic patients. There was no difference in disease-free survival in-between these two groups.

Conclusion: Follow-up routines are indispensable as part of cancer treatment but can be more cost-efficient when patients are educated and encouraged to report subjective symptoms. Trained personnel in collaboration with head and neck specialists can handle parts of follow-up routines.

Keywords: Head and neck; carcinoma; histopathology; radiotherapy; recurrence; second malignancy tumours; surgery; surveillance; survival; treatment.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / therapy*
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Staging
  • Norway / epidemiology
  • Outpatients / statistics & numerical data
  • Prognosis
  • Prospective Studies
  • Self Report*
  • Severity of Illness Index*
  • Survival Rate
  • Tertiary Care Centers
  • Young Adult