Symptom‐based remote assessment in post‐treatment head and neck cancer surveillance: A prospective national study

Autor: Henry, Zhang, John C, Hardman, Theofano, Tikka, Paul, Nankivell, Hisham, Mehanna, Vinidh, Paleri
Rok vydání: 2022
Předmět:
Zdroj: Clinical Otolaryngology. 47:561-567
ISSN: 1749-4486
1749-4478
DOI: 10.1111/coa.13948
Popis: To report the incidence of locoregional recurrence in head and neck cancer (HNC) patients under surveillance following treatment undergoing symptom-based remote assessment.A 16-week multicentre prospective cohort study.UK ENT departments.HNC patients under surveillance following treatment undergoing symptom-based telephone assessment.Incidence of locoregional recurrent HNC after minimum 6-month follow-up.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 those5 years since treatment.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.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje