LAUSR

Abstract Background There is no evidence of effective follow-up for the detection of recurrent head and neck cancer (HNC). There are few reports on the frequency of relapse of platinum-resistant HNC in clinical practice. Local recurrence is often seen during the first two years during which follow-up computed tomography (CT)/magnetic resonance imaging is recommended. The occurrence rate of second cancer (SC) has been reported to be 14.5%. Methods We conducted a retrospective analysis to evaluate the clinical course in 374 patients with head and neck squamous cell carcinoma who underwent definitive treatment at our institute between January 1998 and November 2018. The observation period was until January 2019. Results Recurrence and/or metastasis of HNC (R/M HNC) and SC were seen in 128 and 34 patients, respectively. The sites of R/M HNC were the hypopharynx, oral cavity, and larynx in 30.5%, 21.9%, and 19.5% of the patients, respectively. The sites of SC were the larynx, hypopharynx, and oropharynx in 38.2%, 26.5%, and 20.6% of the patients, respectively. At the diagnosis of relapse of new cancer, 50% of patients with R/M HNC and 44.1% of those with SC were symptomatic. The most common symptom was pain, while other symptoms were swelling, loss of appetite, hoarseness, dysphagia, dyspnea, cough, and bleeding. The modality of detection of recurrence was highest with CT (60.2%), followed by endoscopy (14.1%) and medical examination (14.1%). The median time to recurrence was 6.9 (range, 0 − 141.8) months, with 75% of recurrences occurring within one year. Furthermore, 4.8% of the recurrences occurred after five years. Platinum-resistant relapse accounted for 26.6% of all patients with R/M HNC and 58.6% of the relapses occurred within six months. The median time to recurrence was 35.5 (range, 1.5 − 240.9) months, with 35.3% of the recurrences occurring after five years. Conclusions In clinical practice, it is important to note the timing of rescue treatment during the follow-up period, focusing on imaging and medical examinations and confirming the symptoms within one year of treatment for HNC. During the long-term follow-up, observation for suspected development of SC is necessary. Clinical trial identification . Editorial acknowledgement . Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.