The value of routine follow-up after treatment for head and neck cancer. A National Survey from DAHANCA

Figures & data

Figure 1. Suspicion of recurrence in 99 patients. Investigations and actions (n = 133).

Table I. Patient and tumor characteristics.

Variables	n	%
Gender
Male	422	68
Female	197	32
Age
Median	66
Range	(16–95)
Distribution of tumor site
Nasopharynx	12	2
Oropharynx	199	32
Hypopharynx	36	6
Larynx (glottic)	106	17
Larynx (others)	38	6
Oral cavity	137	22
Sino-nasal	36	6
Salivary gland	27	4
Other	28	5
Treatment
Radiotherapy	253	41
Chemo-radiotherapy	166	27
Postoperative radiotherapy	83	13
Surgery	107	17
Other	10	2
Time since primary treatment
< 1 year	152	25
1–2 years	179	29
2–3 years	116	19
3–4 years	85	14
4–5 years	45	7
> 5 years	42	7
Status at former visit
No recurrence	518	86
Suspicion of recurrent disease	26	4
Treated for recurrence, now disease free	61	10
Patient seen by
Otolaryngologist	55	9
Oncologist	256	41
Joint clinic	304	50
Type of visit:
Planned visit	565	91
Extra visit	44	7
Other	10	2

Table II. Distribution of verified recurrences of disease or new primaries over the follow-up period.

Years since primary treatment	Number of visits in group	Recurrence	New primary	Cum. %
0–1	152	9	0	31%
1–2	179	7	0	55%
2–3	116	3	1	69%
3–4	85	3	1	83%
4–5	45	1	0	86%
5+	42	4	0	100%
Total	619	27	2

Table III. Cross-tabulation of the perception of potential recurrence by the physicians and patients, respectively.

		Physician suspects recurrence
		No	Yes	Verified/ All suspected
Patient suspects recurrence	No	482 (81%)	47 (8%)	7/47 (15%)
	Yes	17 (3%)	52 (9%)	22/52 (42%)

Table IV. Distribution of morbidity and the applied interventions.

Variables	Number of incidences	%
Morbidity
Caries	45	7
Dysphagia/Eating problems	121	20
Low state of nutrition	45	7
Hearing trouble/Tinnitus	10	2
Hoarseness	110	18
Osteonecrosis	12	2
Denture	82	13
Taste disorder	38	6
Pain	57	9
Trismus	26	4
Respiratory problems	5	1
Xerostomia/Viscous mucus	205	33
Other	114	18
Management of Morbidity
None	189	31
Counseling	216	35
Physiotherapist	7	1
Occupational Therapist	4	1
Speech Therapist	11	2
Dietician	1	< 1
Social Worker	2	< 1
Rehabilitation	4	1
Referral to further Investigations	6	1
Medical Prescription	21	3
Dentist	24	4
Jaw Surgeon	8	1
ENT Physician	20	3
Other	24	4

Figure 2. Tumor and treatment-related problems, related to years after primary treatment.