Background:
The duration of follow-up after treatment for head and neck cancer, the depth of the routine visits, and the diagnostic tools used are determined on the basis of common acceptance rather than evidence-based practice. patients with early-stage tumors are more likely to benefit from follow-up programs, because they have the best chance for a second curative treatment after recurrence. the purpose of this study was to determine the benefit of our 10-year follow-up program in patients with stage i and ii squamous cell carcinoma (scc) of the floor of mouth and tongue.
Methods:
In a longitudinal cohort study involving 102 patients who were treated with curative intent for a pt1-2n0m0 scc of the floor of mouth and tongue from 1989-1998 with a minimum follow-up of 5 years, we evaluated the effect of routine follow-up.
Results:
During the follow-up (mean, 61 months; sd, 4 months), 10 patients had a recurrence, and 20 patients had a second primary tumor. no regional lymph node recurrences in the neck were detected. location, t classification of the primary tumor, choice of therapy, or measure of tumor-free margins in the resection did not significantly affect the occurrence of a secondary event (p >or= .1). the secondary event was discovered during a patient-initiated visit for complaints in 14 patients and was found during routine follow-up visits in 16 patients. only seven second primary tumors were detected after 60 months, four on routine follow-up and three on a self-initiated visit. the mean disease-free survival time after treatment of the secondary event was 72 months (sd, 17 months) in the "own initiative" group and 65 months (sd, 13 months) in the routine follow-up group; this difference was not statistically significant (p=.3).
Conclusions:
The effectiveness of a 10-year routine follow-up, even in patients with early-stage oral scc, is very limited. these visits on routine basis can be stopped after 5 years.