Volume 134, Issue 2 pp. 708-716

Original Report

Value of Adherence to Posttreatment Follow-Up Guidelines for Head and Neck Squamous Cell Carcinoma

Ashley Stone BA,

Ashley Stone BA

orcid.org/0000-0002-1191-9552

Albert Einstein College of Medicine, Bronx, New York, USA

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Jianyou Liu MS,

Jianyou Liu MS

Department of Epidemiology & Population Health, Division of Biostatistics, Albert Einstein College of Medicine, Bronx, New York, USA

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Juan Lin PhD,

Juan Lin PhD

Department of Epidemiology & Population Health, Division of Biostatistics, Albert Einstein College of Medicine, Bronx, New York, USA

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Bradley A. Schiff MD,

Bradley A. Schiff MD

orcid.org/0000-0002-5860-3627

Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA

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Thomas J. Ow MD, MS,

Thomas J. Ow MD, MS

orcid.org/0000-0001-9389-2332

Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA

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Vikas Mehta MD, MPH,

Vikas Mehta MD, MPH

orcid.org/0000-0002-0907-2102

Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA

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Richard V. Smith MD,

Corresponding Author

Richard V. Smith MD

[email protected]

orcid.org/0000-0002-5216-6374

Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA

Send correspondence to Richard V. Smith, M.D. 3400 Bainbridge Ave, Bronx, NY 10467, USA. Email: [email protected]

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Ashley Stone BA,

Ashley Stone BA

orcid.org/0000-0002-1191-9552

Albert Einstein College of Medicine, Bronx, New York, USA

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Jianyou Liu MS,

Jianyou Liu MS

Department of Epidemiology & Population Health, Division of Biostatistics, Albert Einstein College of Medicine, Bronx, New York, USA

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Juan Lin PhD,

Juan Lin PhD

Department of Epidemiology & Population Health, Division of Biostatistics, Albert Einstein College of Medicine, Bronx, New York, USA

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Bradley A. Schiff MD,

Bradley A. Schiff MD

orcid.org/0000-0002-5860-3627

Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA

Search for more papers by this author

Thomas J. Ow MD, MS,

Thomas J. Ow MD, MS

orcid.org/0000-0001-9389-2332

Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA

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Vikas Mehta MD, MPH,

Vikas Mehta MD, MPH

orcid.org/0000-0002-0907-2102

Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA

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Richard V. Smith MD,

Corresponding Author

Richard V. Smith MD

[email protected]

orcid.org/0000-0002-5216-6374

Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York, USA

Send correspondence to Richard V. Smith, M.D. 3400 Bainbridge Ave, Bronx, NY 10467, USA. Email: [email protected]

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First published: 26 July 2023

https://doi.org/10.1002/lary.30909

Editor's Note: This Manuscript was accepted for publication on July 04, 2023.

Oral presentation at the Triological Society Combined Sections Meeting in Coronado, CA, USA (January 26–28, 2023).

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives

The utility of intensive posttreatment surveillance of head and neck squamous cell carcinoma (HNSCC) has been debated. The objective is to investigate adherence to the National Comprehensive Cancer Network (NCCN) posttreatment follow-up guidelines and assess the association with recurrence and survival.

Methods

A total of 452 patients diagnosed with HNSCC at an academic medical center in a socioeconomically disadvantaged, urban setting were categorized by adherence to NCCN follow-up guidelines. Survival analyses were conducted to study the association between adherence and the 5-year overall survival and disease-specific survival in the entire cohort and subset of patients with documented recurrence.

Results

We found that 23.5% of patients were adherent to NCCN follow-up guidelines in the first year after treatment, and 15.9% were adherent over 5 years. Adherence in the first year was significantly associated with 5-year overall survival (HR 0.634; 95% CI 0.443–0.906; p = 0.0124) and disease-specific survival (HR 0.556; 95% CI 0.312–0.992; p = 0.0470), but consistent adherence over 5 years did not show a significant association. Among the 21.7% of the cohort with recurrence, adherence was not associated with early-stage recurrence (AJCC stage I/II). In this subset, first year adherence was associated with improved disease-specific but not overall survival, and adherence over 5 years was not associated with survival.

Conclusion

Adherence to NCCN follow-up guidelines in the first year after treatment was associated with a better chance of 5-year overall and disease-specific survival, but this significant association was not observed among those who demonstrated consistent adherence over 5 years.

Level of Evidence

3 Laryngoscope, 134:708–716, 2024

Supporting Information

Filename	Description
lary30909-sup-0001-FigureS1.pdfPDF document, 69.6 KB	Figure S1. Disease-specific survival by adherence to follow-up over 5 years.
lary30909-sup-0002-FigureS2.pdfPDF document, 102.9 KB	Figure S2A. Survival by adherence to follow-up in the first year after treatment: Overall survival. Figure S2B. Survival by adherence to follow-up in the first year after treatment: Disease-specific survival.
lary30909-sup-0003-FigureS3.docxWord 2007 document , 87.4 KB	Figure S3A. Survival by adherence to follow-up over 5 years among patients with recurrence: Overall survival. Figure S3B. Survival by adherence to follow-up over 5 years among patients with recurrence: Disease-specific survival.
lary30909-sup-0004-FigureS4.docxWord 2007 document , 77.2 KB	Figure S4A. Survival by adherence to follow-up in the first year after treatment among patients with recurrence: Overall survival. Figure S4B. Survival by adherence to follow-up in the first year after treatment among patients with recurrence: Disease-specific survival.
lary30909-sup-0005-TableS1.docxWord 2007 document , 16.5 KB	Table S1. Cox proportional hazards model of predictors of 5-year disease-specific survival including adherence to follow-up over 5 years.
lary30909-sup-0006-TableS2.docxWord 2007 document , 16.5 KB	Table S2. Cox proportional hazards model of predictors of 5-year overall survival including adherence to follow-up in the first year after treatment.
lary30909-sup-0007-TableS3.docxWord 2007 document , 16.5 KB	Table S3. Cox proportional hazards model of predictors of 5-year disease-specific survival including adherence to follow-up in the first year after treatment.
lary30909-sup-0008-TableS4.docxWord 2007 document , 16.2 KB	Table S4. Cox proportional hazards model of predictors of 5-year disease-specific survival among patients with recurrence including adherence to follow-up over 5 years.
lary30909-sup-0009-TableS5.docxWord 2007 document , 16.3 KB	Table S5. Cox proportional hazards model of predictors of 5-year overall survival among patients with recurrence including adherence to follow-up in the first year after treatment.
lary30909-sup-0010-TableS6.docxWord 2007 document , 16.3 KB	Table S6. Cox proportional hazards model of predictors of 5-year disease-specific survival among patients with recurrence including adherence to follow-up in the first year after treatment.

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

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Volume134, Issue2

February 2024

Pages 708-716

Value of Adherence to Posttreatment Follow-Up Guidelines for Head and Neck Squamous Cell Carcinoma

Abstract

Objectives

Methods

Results

Conclusion

Level of Evidence

Supporting Information

BIBLIOGRAPHY

References

Information

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Value of Adherence to Posttreatment Follow-Up Guidelines for Head and Neck Squamous Cell Carcinoma

Abstract

Objectives

Methods

Results

Conclusion

Level of Evidence

Supporting Information

BIBLIOGRAPHY

References

Related

Information