Effectiveness of routine follow-up of patients treated for T1-2N0 oral squamous cell carcinomas of the floor of mouth and tongue

Abstract

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 ≥ .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. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX–XXX, 2005