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Symptom-based remote assessment in post-treatment head and neck cancer surveillance: A prospective national study.
Zhang, Henry; Hardman, John C; Tikka, Theofano; Nankivell, Paul; Mehanna, Hisham; Paleri, Vinidh.
  • Zhang H; Head and Neck Unit, Royal Marsden Hospital, London, UK.
  • Hardman JC; Head and Neck Unit, Royal Marsden Hospital, London, UK.
  • Tikka T; Head and Neck Unit, Royal Marsden Hospital, London, UK.
  • Nankivell P; Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK.
  • Mehanna H; Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK.
  • Paleri V; Head and Neck Unit, Royal Marsden Hospital, London, UK.
Clin Otolaryngol ; 47(5): 561-567, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1874404
ABSTRACT

OBJECTIVES:

To report the incidence of locoregional recurrence in head and neck cancer (HNC) patients under surveillance following treatment undergoing symptom-based remote assessment.

DESIGN:

A 16-week multicentre prospective cohort study.

SETTING:

UK ENT departments.

PARTICIPANTS:

HNC patients under surveillance following treatment undergoing symptom-based telephone assessment. MAIN OUTCOME

MEASURES:

Incidence of locoregional recurrent HNC after minimum 6-month follow-up.

RESULTS:

Data for 1078 cases were submitted by 16 centres, with follow-up data completed in 98.9% (n = 1066). Following telephone consultation, 83.7% of referrals had their face-to-face appointments deferred (n = 897/1072). New symptoms were reported by 11.6% (n = 124/1072) at telephone assessment; 72.6% (n = 90/124) of this group were called for urgent assessments, of whom 48.9% (n = 44/90) came directly for imaging without preceding clinical review. The sensitivity and specificity for new symptoms as an indicator of cancer recurrence were 35.3% and 89.4%, respectively, with a negative predictive value of 99.7% (p = .002). Locoregional cancer identification rates after a minimum of 6 months of further monitoring, when correlated with time since treatment, were 6.0% (n = 14/233) <1 year; 2.1% (n = 16/747) between 1 and 5 years; and 4.3% (n = 4/92) for those >5 years since treatment.

CONCLUSIONS:

Telephone assessment, using patient-reported symptoms, to identify recurrent locoregional HNC was widely adopted during the initial peak of the COVID-19 pandemic in the United Kingdom. The majority of patients had no face-to-face reviews or investigations. New symptoms were significantly associated with the identification of locoregional recurrent cancers with a high specificity, but a low sensitivity may limit symptom assessment being used as the sole surveillance method.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Head and Neck Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors / Screening study Limits: Humans Language: English Journal: Clin Otolaryngol Journal subject: Otolaryngology Year: 2022 Document Type: Article Affiliation country: Coa.13948

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Head and Neck Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors / Screening study Limits: Humans Language: English Journal: Clin Otolaryngol Journal subject: Otolaryngology Year: 2022 Document Type: Article Affiliation country: Coa.13948