[Relevance of colour-duplex echography for detection and therapy of recurrences in the follow-up of head and neck cancer].
BACKGROUND
Head and neck malignancies have a high rate of recurrences. Since the prognosis is often limited an early detection and therapy onset is essential for survival. This study surveys the relevance of regular colour-duplex echography examinations in the follow-up for detection and therapy of recurrent head and neck carcinomas.


METHODS
In a prospective non-randomized study 43 patients were surveyed over a mean observation period of 28 (8-44) months. In addition to clinical and colour-duplex echography (CDS) examinations, computed tomography (CT) and positron-emission-tomography using 18fluorodeoxyglucose (PET) were performed.


RESULTS
A recurrence was detected in 17/43 (39.5 %) patients. The median survival was 42 months. CDS was the most reliable procedure for the diagnosis of regional recurrences with an accuracy of 94.2 %. Sensitivity and specificity of CDS for the diagnosis of all recurrences was found to be 80 % and 78,6 % respectively. CT yielded identical results. In PET sensitivity was 82.4 % and specificity was found to be 88.4 %. In clinical examinations including panendoscopy sensitivity was 64.7 % only. In 7/17 recurrences a therapy was performed with curative intention. In 4 cases an early diagnosis by CDS contributed to a successful therapy.


CONCLUSIONS
CDS is the imaging procedure of choice for the routine follow-up of head and neck cancer patients. In order to perform a comprehensive assessment of the head and neck region, for re-staging and to exclude second primary tumours additional (pan)endoscopy is necessary. CDS supports due to a high resolution and reliability an early therapy onset and a minimal invasive therapy. Thus, this procedure can significantly contribute to the successful treatment of recurrences in head and neck cancer.
Di Martino
E
E
Klinik für Hals-Nasen- und Ohren-Heilkunde und Plastische Kopf- und Halschirurgie der Med. Fakultät der RWTH Aachen. edimartino@ukaachen.de
Hausmann
R
R
Krombach
G A
GA
Nowak
B
B
Tietze
L
L
Gagel
B
B
Zimny
M
M
Westhofen
M
M
D000230:Adenocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy; D003528:Carcinoma, Adenoid Cystic / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color
D019788:Fluorodeoxyglucose F18