title: Significance of self-reported symptoms as part of follow-up routines in patients treated for oral squamous cell carcinoma.
abstract: BACKGROUND
  There is little evidence to prove that frequent out-patient consultations lead to better prognosis in patients treated for oral squamous cell carcinoma. Furthermore, there is no consensus regarding the timing and number of follow-up consultations or the duration of monitoring after completed therapy.
  
  
  METHODS
  We prospectively recorded demographic and clinical data of 537 patients treated over a period of 15 years with complete follow-up of 18 years in a tertiary academic Center.
  
  
  RESULTS
  Out of 537 patients considered free of disease after treatment, 196 (36%) developed recurrent disease during follow-up. Self-reported symptoms led to diagnosis of the recurrence in 78% of the cases. Only 22% of recurrences were detected through physical examination of asymptomatic patients. There was no difference in disease-free survival in-between these two groups.
  
  
  CONCLUSIONS
  Follow-up routines are indispensable as part of cancer treatment but can be more cost-efficient when patients are educated and encouraged to report subjective symptoms. Trained personnel in collaboration with head and neck specialists can handle parts of follow-up routines.
authors.affiliation: Department of Oto-rhino-laryngology, Head and Neck Surgery, Oslo University Hospital (OUS), Radiumhospitalet, Oslo, Norway uzatterstrom@gmail.com.
authors.forename: Ulf
authors.initials: U
authors.lastname: Zätterström
authors.affiliation: Department of Oto-rhino-laryngology, Head and Neck Surgery, Oslo University Hospital (OUS), Radiumhospitalet, Oslo, Norway.
authors.forename: Morten
authors.initials: M
authors.lastname: Boysen
authors.affiliation: Department of Cancer Treatment, Oslo University Hospital (OUS), Radiumhospitalet, Oslo, Norway.
authors.forename: Jan Folkvard
authors.initials: JF
authors.lastname: Evensen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D009367:Neoplasm Staging; D009664:Norway / Q000453:epidemiology; D010045:Outpatients / Q000706:statistics & numerical data; D011379:Prognosis; D011446:Prospective Studies; D057566:Self Report; D012720:Severity of Illness Index; D015996:Survival Rate; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Head and neck; carcinoma; histopathology; radiotherapy; recurrence; second malignancy tumours; surgery; surveillance; survival; treatment