title: Postoperative follow-up strategy in patients with oral squamous cell carcinoma.
abstract: OBJECTIVE
  The duration of follow-up after treatment of oral squamous cell carcinoma and the frequency of routine visits are based on common usage rather than evidence-based practice. The purpose of this study was to determine the appropriate postoperative routine follow-up program in patients with oral squamous cell carcinoma.
  
  
  METHODS
  Three hundred four cases treated curatively mainly by surgery at Tokai University Hospital from 1994 to 2004 were analyzed. A secondary event was defined as a local recurrence, a regional recurrence, a distant metastasis, or a second primary cancer. To evaluate the follow-up program, data on the first tumor recurrence or first second primary tumor in the head and neck region or elsewhere in the body were used. Overall survival rate, disease-specific survival rate, relapse-free rate, and cumulative risk of developing a second primary cancer were estimated by the Kaplan-Meier product limit method.
  
  
  RESULTS
  All relapse cases were detected within 3 years postoperatively, of which 86.3% were detected within 1 year. Most relapses were in the neck, and regional recurrences had a dismal salvage rate. Second primary cancers were constantly detected 1 to 10 years postoperatively.
  
  
  CONCLUSIONS
  Follow-up should be performed more frequently in the first year, with 2 weekly follow-ups with monthly ultrasound examinations, and should be continued after 3 years to exclude the development of second primary cancers.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Kanagawa, Japan. sasaki75@is.icc.u-tokai.ne.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Sasaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Aoki
authors.forename: Kazunari
authors.initials: K
authors.lastname: Karakida
authors.forename: Mitsunobu
authors.initials: M
authors.lastname: Otsuru
authors.forename: Miho
authors.initials: M
authors.lastname: Takahashi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Akamatsu
authors.forename: Haruo
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Ota
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D016609:Neoplasms, Second Primary; D015996:Survival Rate; D055815:Young Adult