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Correlation between subjective evaluation of symptoms and objective findings in early recurrent head and neck
Lluís Nisa1, Riccardo La Macchia, Noureddine Boujelbene
1Department of Otorhinolaryngology-Head and Neck Surgery, Hôpital de Sion, Centre Hospitalier du Centre du Valais/Réseau Santé Valais, Sion, Switzerland. llnisa@yahoo.ca
Importance:
This study addresses the value of patients' reported symptoms as markers of tumor recurrence after definitive therapy for head and neck squamous cell carcinoma.
Objective:
To evaluate the correlation between patients' symptoms and objective findings in the diagnosis of local and/or regional recurrences of head and neck squamous cell carcinomas in the first 2 years of follow-up.
Design:
Retrospective single-institution study of a prospectively collected database.
Setting:
Regional hospital.
Participants:
We reviewed the clinical records of patients treated for oral cavity, oropharyngeal, laryngeal, and hypopharyngeal carcinomas between January 1, 2008, and December 31, 2009, with a minimum follow-up of 2 years.
Main Outcomes And Measures:
Correlation between symptoms and oncologic status (recurrence vs remission) in the posttreatment period.
Results:
Of the 101 patients included, 30 had recurrences. Pain, odynophagia, and dysphonia were independently correlated with recurrence (odds ratios, 16.07, 11.20, and 5.90, respectively; P < .001). New-onset symptoms had the best correlation with recurrences. Correlation was better between 6 to 12 and 18 to 21 months after therapy and in patients initially treated unimodally (P < .05). Primary stage and tumor site had no effect.
Conclusions And Relevance:
The correlation between symptoms and oncologic status is low during substantial periods within the first 2 years of follow-up. New-onset symptoms, especially pain, odynophagia, or dysphonia, better correlate with tumor recurrence, especially in patients treated unimodally.