A study published online by JAMA Otolaryngology-Head & Neck Surgery has found that compliance with post-treatment monitoring, income level and travel distance for follow-up care may all be associated with survival rates for patients with head and neck squamous cell cancer.
Head and neck squamous cell cancer has a 5-year survival rate of approximately 50%, and as such post-treatment surveillance is very important for effective patient treatment. The National Comprehensive Cancer Network guidelines recommend follow-up visits every 1–3 months during the first year following treatment, every 2–4 months in the second year, every 4–6 months in the third to fifth years, and yearly thereafter. The recent study identified a number of factors that influence the ability to carry out post-treatment surveillance as recommended.
Researchers from the University of Kansas Medical Center (KS, USA), led by Michael W Deutschmann analyzed data from 332 patients who completed treatment and post-treatment surveillance at the center. The team collected data detailing patient and tumor characteristics, socioeconomic status and geographic information to examine the effect of compliance with post-treatment surveillance on survival. The patients were followed for an average of 45 months.
Of the patients, 74% (246 patients) had advanced disease, and treatments included surgery and radiation, alone or combined, along with chemoradiation and surgery plus chemoradiation. The majority of patients did not relapse (64%; 213 patients).
In terms of geography, more than half of the patients lived 50 miles or less from the treatment facility, while 7% lived over 200 miles away. In addition to this, over half of patients lived in middle census tract income levels and 49% did not miss any appointments. However, 30% of patients missed three or more appointments.
The study identified a relationship between compliance and smoking cessation, in addition to the distance a patient travelled from home to the treatment center. Patients who stopped smoking resided in high-income census tracts and lived closer to the treatment center were more likely than expected to have kept all of their appointments.
“Patients who were compliant with their post-treatment surveillance were significantly more likely to quit tobacco products, and those who quit had improved survival,” the study concluded.