title: Value of routine follow-up for patients cured of laryngeal carcinoma.
abstract: BACKGROUND
  Routine follow-up offered to patients with laryngeal carcinoma in The Netherlands consisted of 22 routine visits over a time period of 10 years after treatment. The primary aims of the follow-up were to detect cancer recurrence in asymptomatic patients and to achieve better survival outcome by reducing cancer-specific mortality rates.
  
  
  METHODS
  A longitudinal cohort study was performed to evaluate the effect of this follow-up schedule. Between January 1990 and January 1995, the authors studied all patients with primary laryngeal squamous cell carcinoma who were treated with intention to cure. For patients who developed cancer recurrence, all routine and extra visits were documented. Reported symptoms and physical evidence of tumor were mapped.
  
  
  RESULTS
  The patients complied with the follow-up protocol closely. In only 2% of all routine visits an asymptomatic cancer recurrence was found. There was no difference in survival and tumor mortality rates for patients with and without symptoms, despite the difference in whether the therapy applied had the intention to cure. It seemed that patients who developed tumor recurrence after therapy for laryngeal carcinoma received no benefit from screening for cancer recurrence detection. The lack of benefit for cancer detection screening among asymptomatic patients might be explained by unfavorable tumor biology parameters.
  
  
  CONCLUSIONS
  The routine follow-up program after treatment for laryngeal carcinoma did not lead to survival benefit for asymptomatic patients with tumor recurrence.
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Nijmegen, The Netherlands.
authors.forename: Savitri C
authors.initials: SC
authors.lastname: Ritoe
authors.forename: Paul F M
authors.initials: PF
authors.lastname: Krabbe
authors.forename: Johannes H A M
authors.initials: JH
authors.lastname: Kaanders
authors.forename: Frank J A
authors.initials: FJ
authors.lastname: van den Hoogen
authors.forename: André L M
authors.initials: AL
authors.lastname: Verbeek
authors.forename: Henri A M
authors.initials: HA
authors.lastname: Marres
mesh_terms: D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D016609:Neoplasms, Second Primary / Q000175:diagnosis; D018307:Neoplasms, Squamous Cell / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome