title: Evaluation of a post-treatment follow-up program in patients with oral squamous cell carcinoma.
abstract: OBJECTIVE
  The duration and the frequency of follow-up after treatment of oral squamous cell carcinoma are not standardized in the current literature. The purpose of this study was to evaluate our local standard post-treatment and follow-up protocol.
  
  
  METHODS
  Overall, 228 patients treated curatively from 01/2006 to 07/2013 were reviewed. To evaluate the follow-up program, data on the secondary event were used. To determine risk groups, all patients with tumor recurrence were specifically analyzed. Relapse-free rate were estimated by the Kaplan-Meier product limit method. The chi-square test was used to identify independent risk factors for tumor relapse.
  
  
  RESULTS
  In total, 29.8 % patients had a secondary event. The majority of the relapse cases (88.2 %) were detected within 2 years postoperatively, 61.8 % of them within the first year. Most events were local recurrences (34.7 %). UICC-stage IV was significantly associated with tumor recurrence (p = 0.001). Gender (p = 0.188), age (p = 0.195), localization (p = 0.739), T-stage (p = 0.35), N-stage (p = 0.55), histologic grade (p = 0.162), and tobacco and alcohol use (p = 0.248) were not significantly associated with tumor recurrence. Patients with positive neck nodes relapsed earlier (p = 0.011). The majority of relapses (86.3 %) were found in asymptomatic patients at routine follow-up.
  
  
  CONCLUSIONS
  The results of this study suggest an intensified follow-up within the first 2 years after surgery.
  
  
  CONCLUSIONS
  Given the higher relapse rate of patients exhibiting an UICC-stage IV and/or positive neck nodes, it seems to be from special interest to perform in this group a risk-adapted follow-up with monthly examinations also in the second year.
authors.affiliation: Department of Cranio-Maxillofacial & Plastic Surgery, Jena University Hospital, Erlanger Allee 101, 07749, Jena, Germany. andre.peisker@med.uni-jena.de.
authors.forename: Andre
authors.initials: A
authors.lastname: Peisker
authors.affiliation: Department of Cranio-Maxillofacial & Plastic Surgery, Jena University Hospital, Erlanger Allee 101, 07749, Jena, Germany.
authors.forename: Gregor Franziskus
authors.initials: GF
authors.lastname: Raschke
authors.affiliation: Department of Surgical Sciences, Marquette University, School of Dentistry, Milwaukee, Wisconsin, 53201-1881, USA.
authors.forename: Arndt
authors.initials: A
authors.lastname: Guentsch
authors.affiliation: Department of Surgical Sciences, Marquette University, School of Dentistry, Milwaukee, Wisconsin, 53201-1881, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Luepke
authors.affiliation: Department of Cranio-Maxillofacial & Plastic Surgery, Jena University Hospital, Erlanger Allee 101, 07749, Jena, Germany.
authors.forename: Korosh
authors.initials: K
authors.lastname: Roshanghias
authors.affiliation: Department of Cranio-Maxillofacial & Plastic Surgery, Jena University Hospital, Erlanger Allee 101, 07749, Jena, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schultze-Mosgau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery*; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Follow-up; Oral squamous cell carcinoma; Risk groups; Tumor recurrence