Role of panendoscopy in identifying and managing risk of head and neck squamous cell carcinoma in routine follow-up: a retrospective clinical evaluation

We discuss the clinical effectiveness and predictive value of routine panendoscopy for surveillance and follow-up of head and neck squamous cell carcinoma (HNSCC). Retrospective comparative study. Department of Otolaryngology-Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Two hundred and four HNSCC patients (follow-up between 2004 and 2007) were retrospectively evaluated. During follow-up, panendoscopy was performed routinely once a year. To avoid unnecessary procedures, we evaluated the value of radiological and clinical parameters in follow-up. On comparing normal-computerized tomography (CT) vs. abnormal CT results, a 13-fold higher frequency of recurrence (odds ratio 12.74; 95% CI 4.22, 38.48; p < 0.001) was found. Additionally, patient medical history, clinical investigation, and recurrence pattern were significant parameters when detecting a possible recurrence. Panendoscopy could have been avoided in 40% of patients with HNSCC (173/432). A follow-up schedule avoiding routine panendoscopy in HNSCC follow-up when the combination of diagnostic parameters is satisfactory does not influence the sensitivity or specificity of the test.