Correlation Between Subjective Evaluation of Symptoms and Objective Findings in Early Recurrent Head and Neck Squamous Cell Carcinoma

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Abstract

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.

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