Role of neck ultrasound during follow-up care of head and neck squamous cell carcinomas

Conclusion: No impact of neck ultrasound on the detection rate of neck recurrences of head and neck squamous cell carcinomas ( HNSCCs) was seen. The outcome of salvage therapy was not influenced by close neck ultrasound monitoring during follow-up. Tendencies of earlier detection of neck recurrences were noticed. Objectives: Neck ultrasound is more feasible for frequent application than computed tomography, while having comparable sensitivity and specificity in detecting neck metastasis. Before this study the effect of neck ultrasound on salvage therapy of neck recurrences when used in short defined intervals during follow-up was unknown. Methods: A total of 140 patients with primarily surgically treated HNSCC were enrolled in a follow-up program with defined close time intervals. Neck ultrasound was applied during every follow-up visit. Recurrence rate, survival rate, and outcome of salvage therapy were determined. Results: Overall recurrences occurred in 35.0% of patients. Local, regional, and distant recurrences were found in 11.4%, 7.9%, and 15.7%. Hypopharyngeal carcinoma and advanced staged tumor showed highest recurrence rates. In all, 24.5% of all recurrences were treated successfully by salvage therapy. Resection of local, regional, and distant recurrences resulted in 3-year survival rates of 43.8%, 36.4%, and 4.5%. The outcome of secondary therapy worsened with advancing initial primary tumor stage.