Screening for local and regional cancer recurrence in patients curatively treated for laryngeal cancer: definition of a high-risk group and estimation of the lead time.
BACKGROUND
All patients treated for laryngeal cancer are offered the same follow-up schedule to detect asymptomatic locoregional recurrences. In this study, we evaluated the prognostic profile of patients for cancer recurrence and estimated the lead time.


METHODS
A cohort study was performed between 1990 and 1995. Cox proportional hazards model was used to analyze the prognostic factors. The effect of altering the follow-up for asymptomatic recurrence detection was determined after estimating the lead time.


RESULTS
The variables cT classification, smoking, and histologic grade proved to be prognostic factors. The risk of locoregional failure was 15% in the low-risk group versus 29% in the high-risk group. The estimated lead time was 2 to 4 weeks.


CONCLUSIONS
Risk profiles for locoregional relapse were defined. Intensifying the follow-up schedule is not advisable because the lead time is very short. An excessively high number of routine visits would have to be performed to increase the detection rate for asymptomatic recurrences.
Ritoe
Savitri C
SC
Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Verbeek
André L M
AL
Krabbe
Paul F M
PF
Kaanders
Johannes H A M
JH
van den Hoogen
Frank J A
FJ
Marres
Henri A M
HA
D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008403:Mass Screening; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology*; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors