title: Impact of positron emission tomography/computed tomography surveillance at 12 and 24 months for detecting head and neck cancer recurrence.
abstract: BACKGROUND
  In head and neck cancer (HNC), 3-month post-treatment positron emission tomography (PET)/computed tomography (CT) reliably identifies persistent/recurrent disease. However, further PET/CT surveillance has unclear benefit. The impact of post-treatment PET/CT surveillance on outcomes is assessed at 12 and 24 months.
  
  
  METHODS
  A 10-year retrospective analysis of HNC patients was carried out with long-term serial imaging. Imaging at 3 months included either PET/CT or magnetic resonance imaging, with all subsequent imaging comprised of PET/CT. PET/CT scans at 12 and 24 months were evaluated only if preceding interval scans were negative. Of 1114 identified patients, 284 had 3-month scans, 175 had 3- and 12-month scans, and 77 had 3-, 12-, and 24-month scans.
  
  
  RESULTS
  PET/CT detection rates in clinically occult patients were 9% (15 of 175) at 12 months, and 4% (3 of 77) at 24 months. No difference in outcomes was identified between PET/CT-detected and clinically detected recurrences, with similar 3-year disease-free survival (41% vs 46%, P = .91) and 3-year overall survival (60% vs 54%, P = .70) rates. Compared with 3-month PET/CT, 12-month PET/CT demonstrated fewer equivocal reads (26% vs 10%, P < .001). Of scans deemed equivocal, 6% (5 of 89) were ultimately found to be positive.
  
  
  CONCLUSIONS
  HNC patients with negative 3-month imaging appear to derive limited benefit from subsequent PET/CT surveillance. No survival differences were observed between PET/CT-detected and clinically detected recurrences, although larger prospective studies are needed for further investigation.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Allen S
authors.initials: AS
authors.lastname: Ho
authors.forename: Gabriel J
authors.initials: GJ
authors.lastname: Tsao
authors.forename: Frank W
authors.initials: FW
authors.lastname: Chen
authors.forename: Tianjie
authors.initials: T
authors.lastname: Shen
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kaplan
authors.forename: A Dimitrios
authors.initials: AD
authors.lastname: Colevas
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Fischbein
authors.forename: Andrew
authors.initials: A
authors.lastname: Quon
authors.forename: Quynh-Thu
authors.initials: QT
authors.lastname: Le
authors.forename: Harlan A
authors.initials: HA
authors.lastname: Pinto
authors.forename: Willard E
authors.initials: WE
authors.lastname: Fee
authors.forename: John B
authors.initials: JB
authors.lastname: Sunwoo
authors.forename: Davud
authors.initials: D
authors.lastname: Sirjani
authors.forename: Wendy
authors.initials: W
authors.lastname: Hara
authors.forename: Mike
authors.initials: M
authors.lastname: Yao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D012008:Recurrence; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult