Current guidelines advocate a follow‐up period of at least 5 years in head and neck cancer. Are there evidence or benefits to support the recommendations?
It's partly historic, established practice is based on empirical evidence. By 5 years post-treatment disease specific mortality becomes asymptotic to the timeline ie the nature of HNSCC is such that everyone who is going to die of recurrent /residual disease does so by 5 years. The maximum mortality rate is in the first year post-treatment and it is less so in the second. As the incidence /prevalence of recurrent /residual disease and risk is so low after 2 years post-treatment, we increasingly follow patients up by phone. Currently the recommendation remains to follow them to five years but this entails opportunity costs in terms of time and money. But with further improvements in biological /chemotherapy and suitable education, counselling and communication, patients may wish this practice to change.
Dr. Michael John Rogers,
Thank you for your highly professional comments. I really learn a lot from your opinions.
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