Can head and neck cancer patients be discharged after three years?

• Published in: Journal of laryngology and otology Vol. 127; no. 10; pp. 991 - 996
• Main Authors: Kumar, R, Putnam, G, Dyson, P, Robson, A K
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.10.2013
• Subjects: Aged; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - therapy; Cohort Studies; Duty to Recontact; Exports; Female; Head & neck cancer; Head and Neck Neoplasms - epidemiology; Head and Neck Neoplasms - therapy; Health Services Accessibility; Hospitals; Human papillomavirus; Humans; Information management; Main Articles; Male; Medical prognosis; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Neoplasms, Unknown Primary; Patient Discharge; Patient Education as Topic; Prospective Studies; Referral and Consultation - organization & administration; Squamous Cell Carcinoma of Head and Neck; Time Factors; Carcinoma, Squamous Cell; Mouth Neoplasms; Laryngeal Neoplasms, Neoplasms; Unknown Primary; Head And Neck Neoplasms; Hypopharyngeal Neoplasms; Duty To Follow Up; Nasopharyngeal Neoplasms; Oropharyngeal Neoplasms
• ISSN: 0022-2151; 1748-5460
• DOI: 10.1017/S0022215113002077

Follow-up surveillance of head and neck cancer patients varies throughout the UK. The heterogeneity of these patients limits the applicability of a standardised protocol. Improvements in our understanding of the natural history of the disease may assist in the tailoring of resources to patients. Prospective data collected at the Cumberland Infirmary over a 13-year period were analysed, primarily focusing upon recurrence rates and time to recurrence. In keeping with other studies, recurrence of head and neck squamous cell carcinoma was found to be maximal within the first three years of treatment, regardless of subsite. Hospital-based surveillance may be safely discontinued after three years for some patients. Laryngeal carcinoma may require further surveillance due to possible delayed recurrence of a second primary formation. Emphasis must be placed on patient education, accessibility to head and neck services, and the existence of a robust system to facilitate urgent referrals.