The authors have no funding, financial relationships, or conflicts of interest to disclose.
Head and Neck
Article first published online: 8 JUN 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 7, pages 1512–1517, July 2012
How to Cite
Beswick, D. M., Gooding, W. E., Johnson, J. T. and Branstetter, B. F. (2012), Temporal patterns of head and neck squamous cell carcinoma recurrence with positron-emission tomography/computed tomography monitoring. The Laryngoscope, 122: 1512–1517. doi: 10.1002/lary.23341
Presented as a poster presentation at the Triological Society Combined Sections Meeting, Scottsdale, Arizona, U.S.A., January 27–29, 2011.
- Issue published online: 21 JUN 2012
- Article first published online: 8 JUN 2012
- Accepted manuscript online: 5 APR 2012 05:05AM EST
- Manuscript Accepted: 16 MAR 2012
- Manuscript Revised: 21 FEB 2012
- Manuscript Received: 6 DEC 2011
- Head and neck;
- squamous cell carcinoma;
- positron-emission tomography/computed tomography;
- Level of Evidence: 4
To estimate the distribution of head and neck squamous cell carcinoma (HNSCC) recurrence after definitive chemoradiation therapy (CRT) among patients who underwent 18F-fluorodeoxyglucose positron-emission tomography and computed tomography (PET/CT) surveillance.
HNSCC patients who underwent definitive CRT from 2001 to 2008 were evaluated for recurrence with serial PET/CT. Patients were excluded if they were previously treated for recurrent disease, were treated with surgery as the primary therapeutic modality, or had inadequate clinical follow-up. Recurrence was defined by histopathologic evidence of tumor.
Three hundred eighty-eight patients were studied. Patients in whom recurrence was not detected were followed clinically and radiographically for a median of 27 months. Tumor recurrence was detected in 110 patients. For 37 patients, recurrence was heralded by clinical signs. Among the 73 asymptomatic patients who had a confirmed recurrence, disease was detected by PET/CT between 2 and 43 months, median of 6 months. Forty-five percent of observed asymptomatic recurrences were detected during the first 6 months of surveillance (95% confidence interval [CI], 34%-57%), 79% within the first 12 months (95% CI, 68%-88%), 95% within the first 24 months (95% CI, 87%-98%), and 100% within the first 48 months (95% CI, 95%-100%).
Among HNSCC patients followed with PET/CT surveillance, 95% of observed asymptomatic recurrences were detected within 24 months after completing CRT. For patients without clinical signs of recurrence, routine PET/CT surveillance beyond the first 24 months may be of limited value and may not be cost effective. Laryngoscope, 2012