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Krutz M, Acharya P, Elliott J, Zhao D, Mhawej R, Queimado L. Tobacco Cessation Following Laryngeal Cancer Diagnosis Predicts Response to Treatment and Laryngectomy-Free Survival. Otolaryngol Head Neck Surg 2024; 170:438-446. [PMID: 37890055 PMCID: PMC10872773 DOI: 10.1002/ohn.567] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/19/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE To determine the effect of tobacco cessation following laryngeal cancer diagnosis on response to first-line therapy, laryngectomy-free survival, and overall survival in patients who were current smokers at the time of diagnosis. STUDY DESIGN Retrospective, case-control study. SETTING OU Stephenson Cancer Center, National Cancer Institute-Designated Cancer Center. METHODS We included 140 patients diagnosed with laryngeal squamous cell carcinoma, who were current smokers at the time of diagnosis, and were treated with first-line definitive radiation or chemo/radiation with the intent to cure. The association between patient characteristics and treatment response was assessed using the χ2 test and logistic regression analysis. Survival outcomes were analyzed using Kaplan-Meier methods and Cox proportional-hazards models. RESULTS Of the 140 current smokers, 61 patients (45%) quit smoking prior to treatment initiation. In adjusted logistic regression analysis, quitters had 3.7 times higher odds of achieving a complete response to first-line therapy than active smokers (odds ratio: 3.694 [1.575-8.661]; P = .003). In the adjusted Cox proportional-hazards model, quitters were 54% less likely to require salvage laryngectomy within 7 years of diagnosis than active smokers (hazard ratio: 0.456 [0.246-0.848]; P = .013). Quitters had a statistically significant increase in 7-year overall survival compared to active smokers (P = .02). CONCLUSION This is the first study to show that in newly diagnosed laryngeal cancer patients who are current smokers at the time of diagnosis, tobacco cessation significantly increases therapy response, laryngectomy-free survival, and overall survival. These data stress the importance of systematically incorporating tobacco cessation programs into laryngeal cancer treatment plans.
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Affiliation(s)
- Matthew Krutz
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
| | - Pawan Acharya
- Department of Biostatistics & Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
| | - Jacey Elliott
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
| | - Daniel Zhao
- Department of Biostatistics & Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Rachad Mhawej
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
| | - Lurdes Queimado
- Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Cell Biology, The University of Oklahoma Health Sciences Center, Oklahoma City OK, USA
- TSET Health Promotion Research Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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2
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van de Weerd C, Geurts SME, Vercoulen RJMT, van Veggel IHF, Brands MT, Marres HAM, Hermens RPMG, van Tol-Geerdink JJ, Kaanders JHAM, Takes RP. Value of routine follow-up for recurrence detection after treatment with curative intent for laryngeal squamous cell carcinoma. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:107304. [PMID: 38043360 DOI: 10.1016/j.ejso.2023.107304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/30/2023] [Accepted: 11/24/2023] [Indexed: 12/05/2023]
Abstract
INTRODUCTION The benefits of routine follow-up after treatment of primary laryngeal squamous cell carcinoma (LSCC) remain disputed. Guidelines worldwide are consensus-based, and evidence for specific subgroups is lacking. This study evaluates routine LSCC follow-up including flexible endoscopy for detecting locoregional recurrence (LRR). METHODS A retrospective cohort of 413 LSCC patients treated between 2006 and 2012 was analysed. The cumulative risk of LRR was calculated. Routine follow-up was evaluated by follow-up visit (routine or interval) at which LRR was detected, LRR treatment intent, and overall survival (OS). Analyses were stratified by early (I-II) and advanced (III-IV) TNM-stage. RESULTS There were 263 (64 %) patients with early-stage and 132 (32 %) patients with advanced-stage LSCC. One-, two- and five-year cumulative risks for LRR after early-stage LSCC were 8 %, 18 %, and 26 %. For advanced-stage LSCC, cumulative risks of LRR were 20 %, 30 %, and 35 %. Of all 69 LRRs after early-stage LSCC, 72 % were routine-detected, 81 % were symptomatic, and 90 % received curative-intent treatment. Of all 45 LRRs following advanced-stage LSCC, 42 % were routine-detected, 84 % were symptomatic, and 62 % received curative-intent treatment. Five-year OS of early-stage LSCC with routine-detected LRR was 70 %, and 72 % for interval-detection (log-rank-p = 0.91). Five-year OS of advanced-stage LSCC with routine-detected LRR was 37 %, and 18 % for interval-detection (log-rank-p = 0.06). CONCLUSIONS Routine follow-up for detecting asymptomatic recurrences seems redundant for early-stage LSCC. After advanced-stage LSCC, no asymptomatic recurrences were detected beyond one year posttreatment despite regular follow-up. Emphasis should be on other follow-up aspects, such as psychosocial support, especially after one year posttreatment.
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Affiliation(s)
- Cecile van de Weerd
- Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands.
| | - Sandra M E Geurts
- Maastricht University Medical Center, Department of Medical Oncology, GROW School for Oncology and Reproduction, Maastricht, the Netherlands
| | - Richard J M T Vercoulen
- Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
| | - Inge H F van Veggel
- Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
| | - Maria T Brands
- Hospital Network Antwerp, Middelheim Medical Center, Department of Oral and Maxillofacial Surgery, Antwerp, Belgium
| | - Henri A M Marres
- Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
| | - Rosella P M G Hermens
- Radboud University Medical Center, Department of IQ Healthcare, Nijmegen, the Netherlands
| | | | - Johannes H A M Kaanders
- Radboud University Medical Center, Department of Radiation Oncology, Nijmegen, the Netherlands
| | - Robert P Takes
- Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
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Brands MT, Swinkels IJ, Aarts AMWM, Verbeek ALM, Merkx MAW, Marres HAM, Kaanders JHAM, Melchers WJG, van Engen-van Grunsven I, Takes RP, Geurts SME. Value of routine follow-up in oropharyngeal squamous cell cancer patients treated with curative intent. Head Neck 2023; 45:586-594. [PMID: 36565244 DOI: 10.1002/hed.27269] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/28/2022] [Accepted: 11/10/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The major goal of routine follow-up in oropharyngeal squamous cell carcinoma (OPSCC) patients is the asymptomatic detection of new disease in order to improve survival. This study evaluated the effect of routine follow-up on overall survival (OS). METHODS A retrospective cohort of 307 consecutive OPSCC patients treated with curative intent between 2006 and 2012 was analyzed. The effectiveness of routine follow-up was studied by comparing treatment-intent and OS in patients with asymptomatically versus symptomatically detected new disease. RESULTS Three- and five-year risks of new disease were 29% (95% CI: 24-34) and 33% (95% CI: 27-39). Of the 81 patients with locoregional recurrence or second primary head and neck cancer, 8 (10%) were detected asymptomatically with no difference in OS with those detected with symptoms. CONCLUSIONS Asymptomatic detection of new disease during routine visits was not associated with improved OS. The focus of follow-up should be on providing psychosocial care and rehabilitation.
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Affiliation(s)
- Maria T Brands
- Netherlands Comprehensive Cancer Organisation, Eindhoven, The Netherlands
| | - Iris J Swinkels
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne M W M Aarts
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - André L M Verbeek
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Matthias A W Merkx
- Netherlands Comprehensive Cancer Organisation, Eindhoven, The Netherlands.,Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Henri A M Marres
- Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Johannes H A M Kaanders
- Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Willem J G Melchers
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Robert P Takes
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Sandra M E Geurts
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University Medical Center, Maastricht, The Netherlands
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4
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Caini S, Del Riccio M, Vettori V, D'Ecclesiis O, Bonomo P, Locatello LG, Salvestrini V, Gallo O, Tagliabue M, Raimondi S, Saieva C, Cozzolino F, Bendinelli B, Gandini S. Post-diagnosis smoking cessation and survival of patients with head and neck cancer: a systematic review and meta-analysis. Br J Cancer 2022; 127:1907-1915. [PMID: 35999273 PMCID: PMC9681856 DOI: 10.1038/s41416-022-01945-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 07/22/2022] [Accepted: 08/01/2022] [Indexed: 11/09/2022] Open
Abstract
Cigarette smoking is the main risk factor for head and neck cancer (HNC) and many HNC patients are active smokers at diagnosis. We conducted a systematic literature review and meta-analysis to quantify the survival impact of smoking cessation at or around the time of HNC diagnosis. We searched studies published until December 31, 2021, and used random-effects meta-analysis to pool study-specific estimates into summary hazard ratio (SHR) and corresponding 95% confidence intervals (CI). Sixteen studies were published between 1983 and 2021, and over 2300 HNC patients were included. Studies were diverse in terms of design, patients, tumours and treatment characteristics, and criteria used to discriminate quitters from continued smokers. HNC patients who quit smoking at or around diagnosis had significantly better overall survival than continued smokers (SHR 0.80, 95% CI 0.70-0.91, n studies = 10). A beneficial effect of post-diagnosis smoking cessation was suggested for other survival endpoints as well, but the results were based on fewer studies (n = 5) and affected by publication bias. Cessation counselling should be offered to all smokers who start a diagnostic workup for HNC and should be considered standard multidisciplinary oncological care for HNC patients. PROSPERO registration number CRD42021245560.
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Affiliation(s)
- Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy.
| | - Marco Del Riccio
- Postgraduate School in Hygiene and Preventive Medicine, University of Florence, Florence, Italy
| | - Virginia Vettori
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Oriana D'Ecclesiis
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Pierluigi Bonomo
- Radiation Oncology, Careggi University Hospital, Florence, Italy
| | | | | | - Oreste Gallo
- Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marta Tagliabue
- Department of Otolaryngology and Head and Neck Surgery, European Institute of Oncology (IEO), IRCCS, Milan, Italy
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Sara Raimondi
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Calogero Saieva
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Flavia Cozzolino
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Benedetta Bendinelli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
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5
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von Kroge PR, Bokemeyer F, Ghandili S, Bokemeyer C, Seidel C. The Impact of Smoking Cessation and Continuation on Recurrence and Survival in Patients with Head and Neck Cancer: A Systematic Review of the Literature. Oncol Res Treat 2020; 43:549-558. [PMID: 32950990 DOI: 10.1159/000509427] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/14/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The impact of smoking continuation or cessation on the outcome of head and neck cancer (HNC) patients concerning recurrence and survival rates is not well understood. We aimed to analyze the prognostic role of smoking habits in patients with newly diagnosed HNC and the effects on survival, recurrence rates, and second primary tumor (SPT) development. METHODS A systematic literature review of the databases PubMed and Web of Science was performed in October 2019 using the search words "head and neck cancer" and "smoking cessation." Articles analyzing the effects of ongoing smoking or smoking cessation in HNC patients were included. RESULTS Twelve studies published from 1993 to 2016 including 6,308 patients with HNC of stages I-IV were eligible for analysis. The median follow-up was 5 years. Six of 8 studies revealed an improved outcome concerning the median overall survival or survival rates favoring smoking cessation. Regarding recurrence rates, 5 of 6 studies indicated a statistically significant benefit associated with smoking cessation, and 2 of 3 studies showed a lower risk for SPT associated with postdiagnosis smoking cessation. CONCLUSION Smoking cessation in patients with newly diagnosed HNC is associated with improved outcomes concerning overall survival, recurrence rates, and SPTs. Further research is needed to validate these results and to evaluate the specific effects on different tumor types and treatment approaches.
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Affiliation(s)
- Patricia R von Kroge
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frederike Bokemeyer
- Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Susanne Ghandili
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Bokemeyer
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Seidel
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,
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6
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Mimica X, Hanson M, Patel SG, McGill M, McBride S, Lee N, Dunn LA, Cracchiolo JR, Shah JP, Wong RJ, Ganly I, Cohen MA. Salvage surgery for recurrent larynx cancer. Head Neck 2019; 41:3906-3915. [PMID: 31433540 DOI: 10.1002/hed.25925] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/01/2019] [Accepted: 08/07/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Despite advances in treatment, the recurrence rates for laryngeal cancer range from 16% to 40%. METHODS Patients with recurrent laryngeal cancer treated at Memorial Sloan Kettering (MSK) from 1999 to 2016 were reviewed. Survival outcomes were analyzed. RESULTS Of 241 patients, 88% were male; the median age was 67 years; 71% had primary glottic tumors. At initial treatment, 72% of patients were seen with early stage disease; primary treatment was radiation (68%), chemoradiation (29%), and surgery (3%). The most common salvage surgery was total laryngectomy (74%). Forty-seven percentage were upstaged at salvage surgery. The 2- and 5-year disease-specific survival (DSS) was 74% and 57%, respectively. Patients with cT4 disease treated with nonsurgical primary management had a 0% 5-year DSS. Independent predictors of DSS were tumor location, perineural invasion, margin, and stage. CONCLUSIONS Salvage surgery results in acceptable oncologic outcomes. Stage, disease site, perineural invasion, and margins are associated with inferior DSS.
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Affiliation(s)
- Ximena Mimica
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martin Hanson
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Snehal G Patel
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marlena McGill
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sean McBride
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nancy Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lara A Dunn
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jennifer R Cracchiolo
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jatin P Shah
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Oncology and Reconstructive Surgery, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Richard J Wong
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ian Ganly
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marc A Cohen
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
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7
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Aarts AMWM, Duffy SW, Geurts SME, Vulkan DP, Houssami N, Zappa M, Nagtegaal ID, Verbeek ALM, Broeders MJM. Towards evidence-based follow-up intervals for breast cancer survivors: Estimates of the preclinical detectable phase of contralateral second breast cancer. Breast 2019; 45:70-74. [PMID: 30884341 DOI: 10.1016/j.breast.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/01/2019] [Accepted: 03/07/2019] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Follow-up schemes in breast cancer survivors are predominantly consensus-based. To determine evidence-based follow-up intervals, estimates of sensitivity of the screening test(s) and duration of the preclinical detectable phase (PCDP) are key. We estimated the sensitivity and the duration of the PCDP of clinical breast examination (CBE) and mammography for the detection of contralateral second breast cancers (CBC) in breast cancer survivors. METHODS Women with a CBC (N = 589) diagnosed in Florence between 1980 and 2005 were included. Test sensitivity and the duration of PCDP were estimated using a simple exponential model of PCDP duration. Analyses were stratified by follow-up period (0-5 vs. >5 years after primary diagnosis) and age at CBC diagnosis (<50 vs. ≥50 years). RESULTS For CBE, test sensitivity was 55% and the duration of the PCDP 16 months. Mammography sensitivity was 91% and duration of the PCDP 35 months. Stratified analyses showed a higher test sensitivity for CBE for women aged <50 (70% vs. 51%). No difference in the duration of PCDP of CBE was found. For mammography, test sensitivity and the duration of the PCDP were higher for women with longer follow-up and in older women. CONCLUSIONS Poor test sensitivity for CBE with a shorter duration of the PCDP compared with mammography were observed. Mammography had high test sensitivity and the potential to detect CBCs early. The estimated duration of the PCDP (35 months) was considerably longer than the recommended follow-up interval (12 months). Future studies are needed to determine whether a longer follow-up interval is appropriate.
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Affiliation(s)
- A M W M Aarts
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - S W Duffy
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - S M E Geurts
- Department of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - D P Vulkan
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - N Houssami
- Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - M Zappa
- Instituto per Lo Studio e La Prevenzione Oncologica (ISPO), Florence, Italy
| | - I D Nagtegaal
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - A L M Verbeek
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands
| | - M J M Broeders
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands; Dutch Expert Centre for Screening, Nijmegen, the Netherlands
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8
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Silverman DA, Puram SV, Rocco JW, Old MO, Kang SY. Salvage laryngectomy following organ-preservation therapy – An evidence-based review. Oral Oncol 2019; 88:137-144. [DOI: 10.1016/j.oraloncology.2018.11.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 11/07/2018] [Accepted: 11/15/2018] [Indexed: 01/07/2023]
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9
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Haapaniemi A, Väisänen J, Atula T, Alho O, Mäkitie A, Koivunen P. Predictive factors and treatment outcome of laryngeal carcinoma recurrence. Head Neck 2016; 39:555-563. [DOI: 10.1002/hed.24642] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 09/12/2016] [Accepted: 10/21/2016] [Indexed: 12/29/2022] Open
Affiliation(s)
- Aaro Haapaniemi
- Department of Otorhinolaryngology – Head and Neck SurgeryHelsinki University Hospital and University of HelsinkiHelsinki Finland
| | - Janne Väisänen
- Department of Otorhinolaryngology – Head and Neck SurgeryOulu University HospitalOulu Finland
- PEDEGO Research UnitUniversity of OuluOulu Finland
- Medical Research Center OuluOulu Finland
| | - Timo Atula
- Department of Otorhinolaryngology – Head and Neck SurgeryHelsinki University Hospital and University of HelsinkiHelsinki Finland
| | - Olli‐Pekka Alho
- Department of Otorhinolaryngology – Head and Neck SurgeryOulu University HospitalOulu Finland
- PEDEGO Research UnitUniversity of OuluOulu Finland
- Medical Research Center OuluOulu Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology – Head and Neck SurgeryHelsinki University Hospital and University of HelsinkiHelsinki Finland
| | - Petri Koivunen
- Department of Otorhinolaryngology – Head and Neck SurgeryOulu University HospitalOulu Finland
- PEDEGO Research UnitUniversity of OuluOulu Finland
- Medical Research Center OuluOulu Finland
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10
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Follow-up of oral cancer patients: three uneventful years may be enough. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:434-9. [PMID: 27496578 DOI: 10.1016/j.oooo.2016.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/29/2016] [Accepted: 05/15/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore the possibility of shortening the length of follow-up from 5 to 3 years in patients who have undergone curative treatment of an oral squamous cell carcinoma. STUDY DESIGN The medical records of 225 patients who had undergone initial curative treatment at the VU University Medical Center in Amsterdam, the Netherlands, between 2004 and 2009 were analyzed. RESULTS In 96 patients (42.7%) a secondary event occurred. Eighty-six percent of the secondary events were detected within 3 years. In the fourth and fifth years, 14% of the secondary events were found, consisting mainly of second primary tumors. CONCLUSIONS Most secondary events occurred within the first 3 years of follow-up. Therefore, the case can be made for an altered regimen of follow-up beyond 3 years based on certain risk factors unique to the patient as well as the patient's ability to adequately report symptoms that may be associated with recurrent disease.
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11
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van Imhoff LC, Kranenburg GG, Macco S, Nijman NL, van Overbeeke EJ, Wegner I, Grolman W, Pothen AJ. Prognostic value of continued smoking on survival and recurrence rates in patients with head and neck cancer: A systematic review. Head Neck 2015; 38 Suppl 1:E2214-20. [DOI: 10.1002/hed.24082] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 01/17/2015] [Accepted: 04/13/2015] [Indexed: 12/13/2022] Open
Affiliation(s)
- Lieke C.R. van Imhoff
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
| | - Gabriëlle G.J. Kranenburg
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
| | - Sven Macco
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
| | - Nicoline L. Nijman
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
| | - Elisabeth J. van Overbeeke
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
| | - Inge Wegner
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
- Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht The Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
- Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht The Netherlands
| | - Ajit J. Pothen
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
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12
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Štefková G, Veselská ZD, Vargová V, Paľo M. The Association of Education, Employment and Living with a Partner with the Treatment among Patients with Head and Neck Cancer. AIMS Public Health 2015; 2:1-9. [PMID: 29546091 PMCID: PMC5690365 DOI: 10.3934/publichealth.2015.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/21/2015] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to explore possible associations between social and socioeconomic status and ongoing treatment among patients with head and neck cancer. MATERIAL AND METHODS Data from 159 examined patients treated with head and neck cancer during the period from 2011 to 2012 were explored. A logistic regression analysis was used to assess association of social status (living with somebody vs. living alone), socioeconomic status (employed vs. unemployed) and education (primary/secondary/university) with treatment. RESULTS The results from logistic regression showed significant association of employment status and education with both interruption in radiochemotherapy and searching for additional help after surgery. Interruption of radiochemotherapy was almost 3 times more likely in a group of unemployed compared to the employed patients. Lack of searching for help after surgery was almost 4 times more likely in a group of unemployed compared to the employed and 5 times more likely in the group with the lowest education compared with the group with the highest education. CONCLUSIONS The study suggests that special attention needs to be paid, not only during but also after treatment, to the patients from low socioeconomic groups.
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Affiliation(s)
- Gabriela Štefková
- Nursing Department, Medical Faculty, PJ Safarik University in Košice, Slovakia
| | | | - Viola Vargová
- 1st Department of Internal Medicine, Medical Faculty, PJ Safarik University in Košice, Slovakia
| | - Marek Paľo
- Department of Radiology of JA Reiman University hospital in Prešov, Slovakia
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Outpatient follow-up appointments for patients having curative treatment for cancer of the head and neck: are the current arrangements in need of change? Br J Oral Maxillofac Surg 2014; 52:681-7. [PMID: 25037165 DOI: 10.1016/j.bjoms.2014.06.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 06/24/2014] [Indexed: 11/22/2022]
Abstract
Although there are recommendations, there is little evidence about the rationale for the frequency and duration of review appointments for patients with cancer of the head and neck. We have recorded the pattern of follow-up in a tertiary cancer centre and its association with survival and recurrent disease. We used clinical letters and a prospectively maintained database to obtain details on 297 patients who were treated curatively for squamous cell carcinoma (SCC) of the oral cavity between 2005 and 2008. Mean (SD) age was 63 (12) years and 58% (n = 171) were male. Most patients were seen about 6 times in year one, 3 times in year 2, twice in year 3, twice in year 4, once or twice in year 5, and once yearly beyond year 5. Fewer clinics were scheduled for and attended by patients over 75 years of age, those with overall clinical grades 0-1, and those treated by operation alone in contrast to those who also had adjuvant radiotherapy. Patients were usually seen about 15 times over the 5 years. Taking into account the stage of the tumour and overall mortality, the number and timing of follow-up visits is adequate for the needs of patients with stage II-IV disease. Those with stage I disease may be considered for discharge after the third year if they are told about the risk factors, and signs and symptoms of recurrent disease, and surveillance in primary care.
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14
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Braakhuis BJM, Brakenhoff RH, Leemans CR. Treatment choice for locally advanced head and neck cancers on the basis of risk factors: biological risk factors. Ann Oncol 2013; 23 Suppl 10:x173-7. [PMID: 22987957 DOI: 10.1093/annonc/mds299] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Patients with locally advanced head and neck squamous cell carcinoma often experience relapse, the cause of poor survival statistics. Relapse occurs following the three main types of treatment, surgery with or without post-operative (chemo)radiotherapy, or chemoradiation (containing cisplatin). Cancer relapse can result from (i) outgrowth of residual tumour cells, sometimes with a number too small to be detected by routine histopathology or (ii) development of another carcinoma in a field of pre-neoplastic cells that has remained after treatment of the primary carcinoma. At this moment, clinical staging is not enough to identify patients who will develop relapse and who need tailored treatment. This review describes the latest knowledge of mechanisms of cancer relapse, addresses the biomarkers of potential interest detectable in the tissue of the tumour or its surgical margins and discusses three biomarkers, human papillomavirus, TP53 and epidermal growth receptor in more detail. Once a marker panel has been established, treatment should be focussed on the patients at risk of relapse by improved tailoring of existing treatment modalities. Also, the implementation of more targeting therapies based on the characteristics of the discovered markers should lead to better survival rates.
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Affiliation(s)
- B J M Braakhuis
- Department of Otolaryngology/Head-Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
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15
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Digonnet A, Hamoir M, Andry G, Haigentz M, Takes RP, Silver CE, Hartl DM, Strojan P, Rinaldo A, de Bree R, Dietz A, Grégoire V, Paleri V, Langendijk JA, Vander Poorten V, Hinni ML, Rodrigo JP, Suárez C, Mendenhall WM, Werner JA, Genden EM, Ferlito A. Post-therapeutic surveillance strategies in head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 2012; 270:1569-80. [DOI: 10.1007/s00405-012-2172-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Accepted: 08/15/2012] [Indexed: 12/17/2022]
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16
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van der Putten L, de Bree R, Kuik D, Rietveld D, Buter J, Eerenstein S, Leemans C. Salvage laryngectomy: Oncological and functional outcome. Oral Oncol 2011; 47:296-301. [DOI: 10.1016/j.oraloncology.2011.02.002] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 01/28/2011] [Accepted: 02/01/2011] [Indexed: 11/28/2022]
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17
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Francis DO, Yueh B, Weymuller EA, Merati AL. Impact of surveillance on survival after laryngeal cancer in the medicare population. Laryngoscope 2010; 119:2337-44. [PMID: 19718759 DOI: 10.1002/lary.20576] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS Routine surveillance is advocated to detect recurrent disease after treatment for laryngeal cancer. This aim of this study was to determine the 1- and 5-year postrecurrence mortality for laryngeal cancers and evaluate whether more intensive surveillance improved survival. STUDY DESIGN Retrospective cohort study. METHODS Patients with recurrent cancers (1992-1999) were identified in a national cancer clinical database. Multivariate analysis was used to evaluate the effect of surveillance on postrecurrence survival. RESULTS Of 2,121 recurrent cancers identified, 913 were laryngeal. Patients with laryngeal cancer recurrence had 27% (P = .001) and 22% (P = .007) better odds of 1- and 5-year survival than other sites. The 1- and 5-year postrecurrence survival rates for laryngeal cancer patients were 72.4% and 41.3%, respectively. Glottic cancer cases had the best postrecurrence life expectancy. Multivariate regression revealed that clinical surveillance intensity had no independent impact on their survival (P < .05). However, patients with recurrent glottic cancer seen in surveillance had 23% improved odds of survival (P = .037). CONCLUSIONS More frequent surveillance visits was not associated with a survival advantage in the overall population. Patients with glottic cancer had a postrecurrence survival advantage if seen during the surveillance period. Laryngeal cancer patients had better postrecurrence survival than other head and neck sites.
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Affiliation(s)
- David O Francis
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington 98195, USA.
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18
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Outcome of conservation surgery for laryngeal carcinoma: an 8-year trial. Eur Arch Otorhinolaryngol 2009; 266:1681-6. [DOI: 10.1007/s00405-009-1085-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Accepted: 08/24/2009] [Indexed: 10/20/2022]
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Sethi S, Lu M, Kapke A, Benninger MS, Worsham MJ. Patient and tumor factors at diagnosis in a multi-ethnic primary head and neck squamous cell carcinoma cohort. J Surg Oncol 2009; 99:104-8. [PMID: 19034903 DOI: 10.1002/jso.21190] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND A long-term objective is to refine patient diagnosis and prognosis to address heterogeneity in head and neck squamous cell carcinoma (HNSCC) through incorporation of patient and tumor factors. This study examined histopathology and demographic variables at primary diagnosis (early vs. late stage) in a HNSCC patient population with a higher than usual percentage of African American (AA) subjects. METHODS The primary HNSCC cohort was drawn from a diverse patient population and constructed through re-review of the primary biopsy. Nine specific histopathology and patient factors (race, gender, age) at primary HNSCC diagnosis were evaluated. Logistic regression analyses incorporated univariate and multivariable modeling. RESULTS Race, gender, pattern of invasion, tumor necrosis, perineural invasion, site, and tumor grade were included in the first multivariable model. The final multivariable model retained gender, race, grade, site, and perineural invasion as independent risk factors for late stage with goodness-of-fit, the area under the curve (AUC), as 0.691. CONCLUSIONS This report emphasizes patient and tumor characteristics of race, gender, site, perineural invasion, grade, and pattern of invasion as independent factors of advanced stage HNSCC. Pattern of invasion and necrosis are also important tumor characteristics of late stage disease. These factors may offer clinical perspectives when evaluating patients with indeterminate stage.
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Affiliation(s)
- Seema Sethi
- Department of Otolaryngology/Head and Neck Surgery, Henry Ford Health Systems, Detroit, MI 48202, USA
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