title: Role of panendoscopy in identifying and managing risk of head and neck squamous cell carcinoma in routine follow-up: a retrospective clinical evaluation.
abstract: We discuss the clinical effectiveness and predictive value of routine panendoscopy for surveillance and follow-up of head and neck squamous cell carcinoma (HNSCC). Retrospective comparative study. Department of Otolaryngology-Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Two hundred and four HNSCC patients (follow-up between 2004 and 2007) were retrospectively evaluated. During follow-up, panendoscopy was performed routinely once a year. To avoid unnecessary procedures, we evaluated the value of radiological and clinical parameters in follow-up. On comparing normal-computerized tomography (CT) vs. abnormal CT results, a 13-fold higher frequency of recurrence (odds ratio 12.74; 95% CI 4.22, 38.48; p < 0.001) was found. Additionally, patient medical history, clinical investigation, and recurrence pattern were significant parameters when detecting a possible recurrence. Panendoscopy could have been avoided in 40% of patients with HNSCC (173/432). A follow-up schedule avoiding routine panendoscopy in HNSCC follow-up when the combination of diagnostic parameters is satisfactory does not influence the sensitivity or specificity of the test.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany, AdrianMuenscher@gmx.de.
authors.forename: Adrian
authors.initials: A
authors.lastname: Münscher
authors.forename: Susanne
authors.initials: S
authors.lastname: Sehner
authors.forename: Jegane
authors.initials: J
authors.lastname: Taleh
authors.forename: Silke
authors.initials: S
authors.lastname: Tribius
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Möckelmann
authors.forename: Arne
authors.initials: A
authors.lastname: Böttcher
authors.forename: Amit
authors.initials: A
authors.lastname: Gulati
authors.forename: Carsten
authors.initials: C
authors.lastname: Dalchow
authors.forename: Till
authors.initials: T
authors.lastname: Clauditz
authors.forename: Rainald
authors.initials: R
authors.lastname: Knecht
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D019468:Disease Management; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed / Q000379:methods