title: The impact of compliance in posttreatment surveillance in head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  Posttreatment surveillance (PTS) is a key component in the treatment of patients with head and neck cancer. It is unclear how beneficial this is in improving patients' survival.
  
  
  OBJECTIVE
  To determine how compliance with follow-up affects clinical outcomes in patients with head and neck squamous cell carcinoma.
  
  
  METHODS
  This was a retrospective cohort study at a tertiary academic center of a total of 332 patients with head and neck squamous cell carcinoma who had completed both treatment and follow-up at the University of Kansas Medical Center. Patient and tumor characteristics, socioeconomic status, and geographic data were collected.
  
  
  METHODS
  Compliance with PTS.
  
  
  METHODS
  The effect of compliance with PTS on overall survival.
  
  
  RESULTS
  Compliance with PTS, US Census tract income level, and the distance patients travel for follow-up had significant effects on survival (P = .001, P = .001, and P = .01, respectively). Cox proportional hazard models revealed that more advanced disease (hazard ratio [HR], 1.76 [95% CI, 1.21-2.58]; P = .003), middle (HR, 1.64 [95% CI, 1.13-2.39]; P = .009) and moderate (HR, 1.90 [95% CI, 1.18-3.06]; P = .008) census tract income level, and age (HR, 1.03 [95% CI, 1.01-1.04]; P < .001), were significantly associated with an increased risk of death. There was an association between compliance and tobacco cessation (P = .003), as well as the distance a patient lived from the medical center (P = .008).
  
  
  CONCLUSIONS
  Patients with head and neck squamous cell carcinoma were significantly more likely to survive with completion of follow-up and tobacco cessation. Compliance with PTS was associated with smoking cessation and traveling less than 200 miles for follow-up.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Deutschmann
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Sykes
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine.
authors.forename: John
authors.initials: J
authors.lastname: Harbison
authors.affiliation: Department of Otolaryngology, University of Colorado, Aurora.
authors.forename: Cristina
authors.initials: C
authors.lastname: Cabrera-Muffly
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City.
authors.forename: Yelizaveta
authors.initials: Y
authors.lastname: Shnayder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016540:Smoking Cessation / Q000706:statistics & numerical data; D016019:Survival Analysis; D015996:Survival Rate; D028761:Withholding Treatment / Q000706:statistics & numerical data*; D055815:Young Adult