Personalizing Surveillance in Head and Neck Cancer.

Area of Science:

• Oncology
• Cancer Research

Background:

• Head and neck squamous cell carcinoma (HNSCC) represents a group of diverse cancers affecting the oral cavity, pharynx, and larynx.
• Head and neck cancer (HNC) incidence is increasing, particularly oropharyngeal cancers, accounting for 3% of annual US malignancies.
• Existing post-treatment surveillance guidelines for HNC are broad and do not adequately consider subsite-specific or etiologic factors like HPV status or tobacco use.

Purpose of the Study:

• To highlight the heterogeneity of HNC and the need for personalized post-treatment surveillance strategies.
• To emphasize the importance of surveillance in detecting recurrence, metastases, and second primary malignancies.
• To underscore the role of surveillance in managing treatment complications and improving patient survival and function.

Main Methods:

• Review of current literature and guidelines for HNC surveillance.
• Analysis of HNC heterogeneity based on anatomic subsites and etiologic factors.
• Discussion of incorporating physical examination, imaging, and molecular biomarkers into surveillance protocols.

Main Results:

• HNC surveillance is crucial for early detection of disease recurrence and complications.
• Current surveillance lacks specificity due to the heterogeneity of HNC.
• Tailored surveillance approaches considering HPV status and tobacco exposure are needed.

Conclusions:

• Post-treatment surveillance for HNC requires refinement to account for disease heterogeneity.
• Integrating advanced methods like molecular biomarkers can enhance surveillance effectiveness.
• Personalized surveillance strategies are essential for improving functional outcomes and survival in HNC patients.