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Publications

Journal Article Ahead of print

PubMed: 42924864 DOI: 10.1177/03008916261491111

Symptom-based vs radiological follow-up in head and neck squamous cell carcinoma: A systematic review.

Tumori

Authors: Riccardo Gili, Fausto Petrelli, Andrea Esposito, Carlo Resteghini, Teresa Naccarelli, Massimiliano Nardone, Andrea Esposito, Paolo Bossi

Affiliations

  • UO Oncology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy. Department of Internal Medicine and Medical Specialties, University of Genova, Genova, Italy.
  • Oncology Unit, Azienda Socio Sanitaria Territoriale Bergamo Ovest, Treviglio, Italy.
  • Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy.
  • Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
  • Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy.
  • Otolaringology Unit, Azienda Socio Sanitaria Territoriale Bergamo Ovest, Treviglio, Italy.
  • Radiotherapy Unit, Azienda Socio Sanitaria Territoriale Bergamo Ovest, Treviglio, Italy.

Abstract

BACKGROUND

The optimal follow-up strategy for head and neck squamous cell carcinoma (HNSCC) remains uncertain, with inconsistent international guidelines regarding routine radiological surveillance.

METHODS

A systematic search of PubMed/MEDLINE, EMBASE, and CENTRAL (to April 2025) identified studies including adults with HNSCC undergoing different follow-up modalities. Primary outcomes were overall (OS) and disease-free survival (DFS); secondary outcomes included recurrence detection mode, salvageability, and diagnostic accuracy.

RESULTS

Eighteen retrospective studies met inclusion criteria. Most recurrences (61.5%) were symptom-detected, followed by clinical (24%) and imaging (14.5%) surveillance. Salvageable recurrences were more frequent in symptom-based (60%) than clinical (45%) or imaging (30%) strategies. Across eight studies with survival data, no significant OS or DFS differences emerged between radiological and non-radiological strategies.

CONCLUSION

Available evidence does not demonstrate a survival advantage associated with routine radiological surveillance after curative treatment for HNSCC. and may be limited to symptomatic cases, inaccessible sites, or early post-treatment assessment.

MeSH

Cells, Carcinoma, Squamous Cell, Neoplasms, Signs And Symptoms, Squamous Cell Carcinoma Of Head And Neck, Therapeutics