Is routine follow-up useful after combined-modality therapy for advanced head and neck cancer?

OBJECTIVE

To evaluate the usefulness of routine follow-up in a selected group of patients with head and neck cancer.

DESIGN

Retrospective cohort study with follow-up of 5 years for all patients.

PATIENTS

Three hundred two patients with advanced (stage II or IV) squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx were treated with curative intent with surgery and postoperative radiation therapy between January 1, 1970, and December 31, 1990.

MAIN OUTCOME MEASURE

Survival after recurrence of the index tumor or the development of a second head and neck primary tumor.

RESULTS

Overall actuarial 5-year survival was 56%. Relapse occurred in 119 patients, and salvage therapy was attempted in 49 patients. Only 2 patients survived to 5 years after relapse.

CONCLUSION

In patients with advanced head and neck squamous cell carcinoma, routine follow-up is more important for evaluation of treatment results and emotional support than of benefit in improving patient survival.