Brouwer J, Bree R, Hoekstra O S, Langendijk J A, Castelijns J A, Leemans C R
Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Clin Otolaryngol. 2005 Oct;30(5):438-43. doi: 10.1111/j.1365-2273.2005.01068.x.
The detection of distant metastases during screening influences the choice of treatment in patients with head and neck squamous cell carcinoma (HNSCC). There is no consensus on the diagnostic technique that has to be used nor on the subgroup of HNSCC patients that may benefit from screening.
Questionnaire on current practice concerning the diagnostic work-up in HNSCC patients for screening for distant metastases.
Investigators in the 12 otolaryngology / head and neck and seven oromaxillofacial departments treating head and neck cancer in the Netherlands.
The response rate was 100%. Indications for screening were cervical lymph node metastases (63%), mutilating surgery (58%), locoregional recurrence (47%), advanced T-stage (32%), second primary tumour (21%). Diagnostic techniques routinely used for screening besides chest X-ray were chest CT (84%), liver ultrasound (53%), liver CT (16%) and bone scintigraphy (42%). Forty-two per cent of the clinicians were not satisfied with the current methods of screening.
This survey shows a substantial variation in indications and diagnostic techniques used for screening for distant metastases between the major institutions treating head and neck cancer in the Netherlands. There is a need for guidelines for screening for distant metastases in patients with head and neck cancer.
在头颈部鳞状细胞癌（HNSCC）患者的筛查过程中，远处转移的检测会影响治疗方案的选择。对于必须使用的诊断技术以及可能从筛查中获益的HNSCC患者亚组，目前尚无共识。
关于HNSCC患者远处转移筛查诊断检查的当前实践调查问卷。
荷兰12个耳鼻喉科/头颈科以及7个口腔颌面外科治疗头颈癌的研究人员。
回复率为100%。筛查的指征包括颈部淋巴结转移（63%）、毁形性手术（58%）、局部区域复发（47%）、T分期较晚（32%）、第二原发肿瘤（21%）。除胸部X线外，常规用于筛查的诊断技术有胸部CT（84%）、肝脏超声（53%）、肝脏CT（16%）和骨闪烁显像（42%）。42%的临床医生对当前的筛查方法不满意。
本次调查显示，荷兰主要的头颈癌治疗机构在远处转移筛查的指征和诊断技术方面存在很大差异。有必要制定头颈部癌患者远处转移筛查的指南。
