The timing and methods for detection of recurrence in patients with head and neck cancer

Abstract

Background Early detection of head and neck cancer recurrence after curative treatment is crucial for effective salvage treatment. Objective We aimed to examine the timing and method that allowed early detection of recurrence in each primary and recurrence site. Materials and methods We enrolled 440 patients with head and neck squamous cell carcinoma (HNSCC) in the oral cavity, oropharynx, hypopharynx, or larynx who underwent curative treatment focusing on surgery at our hospital between 2009 and 2018. We examined the timing and diagnostic method (clinical examination, patient symptoms, or imaging examination) for HNSCC recurrence according to the primary and recurrence sites. Results Recurrence was observed in 133 patients. In all primary sites, regional recurrence occurred significantly earlier than local and distant recurrences. Local recurrence occurred later in the larynx than in other primary sites. Furthermore, the clinical examination had a higher ratio of detection of local recurrence in the larynx than in the other primary site. Regardless of the primary site, more than half of the regional recurrences and most of the distant recurrences were detected by imaging examination. Conclusions and significance Imaging examination is preferable for achieving early detection of regional and distant recurrences.