A survey on pulmonary screening practices among otolaryngology-head & neck surgeons across Canada in the post treatment surveillance of head and neck squamous cell carcinoma

Journal of Otolaryngology-Head & Neck Surgery

Michael P Hier¹  Alex M Mlynarek¹  Martin J Black¹  Luz Barona-Lleo²  Gregoire B Morand¹  J Madana¹ 

[1] Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada;Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, MI, USA

关键词: Canadian head and neck surgeons;    Survey;    Pulmonary screening;    Head and neck cancer;   

Others  :  1132926
DOI  :  10.1186/s40463-015-0057-7

 received in 2014-06-19, accepted in 2015-01-16,  发布年份 2015

【 摘 要 】

Background

Post treatment lung screening for head and neck cancer patients primarily focuses on the distant metastasis and a high rate of second primary can also be expected. The best screening tool and timing for this purpose is controversial. We sought out to assess the current practice and beliefs among Canadian Head and Neck Surgeons.

Methods

After Ethical Board approval, a nationwide survey was conducted through the Canadian Society of Otolaryngology (CSO) among head and neck surgeons regarding their practices for pulmonary screening in HNSCC patients.

Results

Our CSO survey among Otolaryngology-head and neck surgeons showed that 26 out of 32 respondents perform routine lung screen, out of which 23 (88%) feel that chest radiography should be preferred. The majority of respondents felt that lung screening could impact beneficially on mortality. For symptomatic patients, low-dose spiral CT was the preferred modality (48%), followed by PET/CT scan (14%) and sputum cytology (14%). In high-risk asymptomatic patients (current smoker, radiation exposure, family history and advanced HNSCC), 31% of respondents performed a CXR. The same percentage performed a low dose CT, while 19% relied on PET scan. A further 19% of respondents did not perform any screening in high-risk patients. Most respondents (77%) had more than 10 years practice since graduation from medical school and came from the provinces of Quebec, Ontario and Alberta.

Conclusion

Chest radiography remains the preferred modality for lung screening and was believed to be impacting beneficially on lung mortality. The recent literature does not seem to be in agreement with those beliefs. Further studies to establish which modality is best and concurrent nation-wide education are warranted.

【 授权许可】

   
2015 Madana et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]de Bree R, Deurloo EE, Snow GB, Leemans CR: Screening for distant metastases in patients with head and neck cancer. Laryngoscope 2000, 110:397-401.
• [2]Zbaren P, Lehmann W: Frequency and sites of distant metastases in head and neck squamous cell carcinoma. An analysis of 101 cases at autopsy. Arch Otolaryngol--Head Neck Surg 1987, 113:762-764.
• [3]Slaughter DP, Southwick HW, Smejkal W: Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin. Cancer 1953, 6:963-968.
• [4]Spector ME, Chinn SB, Rosko AJ, Worden FP, Ward PD, Divi V, McLean SA, Moyer JS, Prince ME, Wolf GT, et al.: Diagnostic modalities for distant metastasis in head and neck squamous cell carcinoma: are we changing life expectancy? Laryngoscope 2012, 122:1507-1511.
• [5]Warner GC, Cox GJ: Evaluation of chest radiography versus chest computed tomography in screening for pulmonary malignancy in advanced head and neck cancer. J Otolaryngol 2003, 32:107-109.
• [6]Engelen AM, Stalpers LJ, Manni JJ, Ruijs JH: Yearly chest radiography in the early detection of lung cancer following laryngeal cancer. Eur Arch Oto-Rhino-Laryngol 1992, 249:364-369.
• [7]Roland NJ, Bradley PJ: The role of surgery in the palliation of head and neck cancer. Curr Opin Otolaryngol Head Neck Surg 2014, 22:101-108.
• [8]Florescu C, Thariat J: Local ablative treatments of oligometastases from head and neck carcinomas. Crit Rev Oncol Hematol 2014, 91(1):47-63.
• [9]Timmerman R, Paulus R, Galvin J, Michalski J, Straube W, Bradley J, Fakiris A, Bezjak A, Videtic G, Johnstone D, et al.: Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA 2010, 303:1070-1076.
• [10]Vikram B: Changing patterns of failure in advanced head and neck cancer. Arch Otolaryngol 1984, 110:564-565.
• [11]Shah SI, Applebaum EL: Lung cancer after head and neck cancer: role of chest radiography. Laryngoscope 2000, 110:2033-2036.
• [12]Xu G, Li J, Zuo X, Li C: Comparison of whole body positron emission tomography (PET)/PET-computed tomography and conventional anatomic imaging for detecting distant malignancies in patients with head and neck cancer: a meta-analysis. Laryngoscope 2012, 122:1974-1978.
• [13]Huber GF, Zullig L, Soltermann A, Roessle M, Graf N, Haerle SK, Studer G, Jochum W, Moch H, Stoeckli SJ: Down regulation of E-Cadherin (ECAD) - a predictor for occult metastatic disease in sentinel node biopsy of early squamous cell carcinomas of the oral cavity and oropharynx. BMC Cancer 2011, 11:217. 1-8 BioMed Central Full Text
• [14]Leong SC, Javed F, Elliot S, Mortimore S: Effectiveness of X-ray and computed tomography screening for assessing pulmonary involvement in patients with head and neck squamous cell carcinoma. J Laryngol Otol 2008, 122:961-966.
• [15]Wilson J, Jungner G: Principles and Practice of Screening for Disease. World Health Organization, Geneva, Switzerland; 1968.
• [16]Zwahlen M, Low N, Borisch B, Egger M, Kunzli N, Obrist R, Paccaud F, Zybach U, Probst-Hensch NM: Population based screening - the difficulty of how to do more good than harm and how to achieve it. Swiss Med Wkly 2010, 140:w13061.
• [17]Alvi A, Johnson JT: Development of distant metastasis after treatment of advanced-stage head and neck cancer. Head Neck 1997, 19:500-505.
• [18]Kowalski LP, Carvalho AL, Martins Priante AV, Magrin J: Predictive factors for distant metastasis from oral and oropharyngeal squamous cell carcinoma. Oral Oncol 2005, 41:534-541.
• [19]McBride SM, Ali NN, Margalit DN, Chan AW: Active tobacco smoking and distant metastasis in patients with oropharyngeal cancer. Int J Radiat Oncol Biol Phys 2012, 84:183-188.
• [20]Huang SH, Perez-Ordonez B, Liu FF, Waldron J, Ringash J, Irish J, Cummings B, Siu LL, Kim J, Weinreb I, et al.: Atypical clinical behavior of p16-confirmed HPV-related oropharyngeal squamous cell carcinoma treated with radical radiotherapy. Int J Radiat Oncol Biol Phys 2012, 82:276-283.
• [21]Ruzevick J, Olivi A, Westra WH: Metastatic squamous cell carcinoma to the brain: an unrecognized pattern of distant spread in patients with HPV-related head and neck cancer. J Neurooncol 2013, 112:449-454.
• [22]Brouwer J, de Bree R, Hoekstra OS, Golding RP, Langendijk JA, Castelijns JA, Leemans CR: Screening for distant metastases in patients with head and neck cancer: is chest computed tomography sufficient? Laryngoscope 2005, 115:1813-1817.
• [23]Noij DP, Boerhout EJ, den Bos IC P-v, Comans EF, Oprea-Lager D, Reinhard R, Hoekstra OS, de Bree R, de Graaf P, Castelijns JA: Whole-body-MR imaging including DWIBS in the work-up of patients with head and neck squamous cell carcinoma: A feasibility study. Eur J Radiol 2014, 83(7):1144-51.
• [24]Murano T, Minamimoto R, Senda M, Uno K, Jinnouchi S, Fukuda H, Iinuma T, Tsukamoto E, Terauchi T, Yoshida T, et al.: Radiation exposure and risk-benefit analysis in cancer screening using FDG-PET: results of a Japanese nationwide survey. Ann Nucl Med 2011, 25:657-666.
• [25]Humphrey LL, Deffebach M, Pappas M, Baumann C, Artis K, Mitchell JP, Zakher B, Fu R, Slatore CG: Screening for lung cancer with low-dose computed tomography: a systematic review to update the US Preventive services task force recommendation. Ann Intern Med 2013, 159:411-420.
• [26]Manser R, Lethaby A, Irving LB, Stone C, Byrnes G, Abramson MJ, Campbell D: Screening for lung cancer. Cochrane Database Syst Rev 2013., 6
• [27]Price KA, Cohen EE: Current treatment options for metastatic head and neck cancer. Curr Treat Options Oncol 2012, 13:35-46.
• [28]Rachmat L, Vreeburg GC, de Vries N, Hordijk GJ, Lubsen H, Manni JJ, Snow GB: The value of twice yearly bronchoscopy in the work-up and follow-up of patients with laryngeal cancer. Eur J Cancer 1993, 29A:1096-1099.
• [29]Hsu YB, Chu PY, Liu JC, Lan MC, Chang SY, Tsai TL, Huang JL, Wang YF, Tai SK: Role of chest computed tomography in head and neck cancer. Arch Otolaryngol--Head Neck Surg 2008, 134:1050-1054.
• [30]Stalpers LJ, van Vierzen PB, Brouns JJ, Bruaset I, Manni JJ, Verbeek AL, Ruys JH, van Daal WA: The role of yearly chest radiography in the early detection of lung cancer following oral cancer. Int J Oral Maxillofac Surg 1989, 18:99-103.
• [31]Merkx MA, Boustahji AH, Kaanders JH, Joosten F, Marres HA, Bruaset I, de Wilde PC: A half-yearly chest radiograph for early detection of lung cancer following oral cancer. Int J Oral Maxillofac Surg 2002, 31:378-382.