Investigation of Recurrent Cases of Head and Neck Cancer after Initial Treatment

AbstractThe optimal follow-up strategy for patients with head and neck cancer after primary treatment is still under debate. This study aimed to review the data of patients with recurrence and evaluate our follow-up strategy. Patients with head and neck cancer who underwent surgery or chemoradiotherapy as the primary treatment between 2012 and 2016 were enrolled. All the patients were carefully followed up at our institution via intensive clinical examination and routine computed tomography (CT) and positron emission tomography (PET)/CT. Recurrence was detected in 20 of the patients treated by surgery and 25 of 96 patients treated by chemoradiotherapy. In more than 90% of the patients, recurrence occurred within 2 years of the primary treatment. Among the patients with recurrence, 11 showed local recurrence, 17 showed regional recurrence, and 17 others showed distant metastasis. In almost all patients with distant metastases, recurrence was detected using CT or PET/CT, whereas among the patients with local or regional recurrence, recurrence was detected based on the patients' complaints and their clinical examination results. Only salvage surgery was observed to be associated with disease-free survival after recurrence. Thus, analysis of the recurrence patterns and appropriate surveillance can result in improved salvage treatment for patients with recurrence.