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<meta name="HW.identifier" content="/ajnr/early/2024/11/21/ajnr.A8392.atom" />
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<meta name="DC.Title" content="Does Long-Term Surveillance Imaging Improve Survival in Patients Treated for Head and Neck Squamous Cell Carcinoma? A Systematic Review of the Current Evidence" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8392" />
<meta name="DC.Date" content="2024-11-21" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND: Long-term posttreatment surveillance imaging algorithms for head and neck squamous cell carcinoma are not standardized due to debates over optimal surveillance strategy and efficacy. Consequently, current guidelines do not provide long-term surveillance imaging recommendations beyond 6 months.

PURPOSE: We performed a systematic review to evaluate the impact of long-term imaging surveillance (ie, imaging beyond 6 months following completion of treatment) on survival in patients treated definitively for head and neck squamous cell carcinoma.

DATA SOURCES: A search was conducted on PubMed, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and the Web of Science for English literature published between 2003 and 2024 evaluating the impact of long-term surveillance imaging on survival in patients with head and neck squamous cell carcinoma.

STUDY SELECTION: We screened 718 abstracts and performed full-text review for 95 abstracts, with 2 articles meeting the inclusion criteria. The Risk of Bias in Non-Randomized Studies of Interventions assessment tool was used.

DATA ANALYSIS: A qualitative assessment without a pooled analysis was performed for the 2 studies meeting inclusion criteria.

DATA SYNTHESIS: No randomized prospective controlled trials were identified. Two retrospective 2-arm studies were included comparing long-term surveillance imaging with clinical surveillance and were each rated as having a moderate risk of bias. Each study included heterogeneous populations with variable risk profiles and imaging surveillance protocols. Both studies investigated the impact of long-term surveillance imaging on overall survival and came to different conclusions, with 1 study reporting a survival benefit for long-term surveillance imaging with FDG-PET/CT in patients with stage III or IV disease or an oropharyngeal primary tumor and the other study demonstrating no survival benefit.

LIMITATIONS: Limited heterogeneous retrospective data available precludes definitive conclusions on the impact of long-term surveillance imaging in head and neck squamous cell carcinoma.

CONCLUSIONS: There is insufficient quality evidence regarding the impact of long-term surveillance imaging on survival in patients treated definitively for head and neck squamous cell carcinoma. There is a lack of a standardized definition of long-term surveillance, variable surveillance protocols, and inconsistencies in results reporting, underscoring the need for a prospective multicenter registry assessing outcomes.

CFU
:   clinical follow-up
CR
:   complete response
CRT
:   chemoradiotherapy
HNSCC
:   head and neck squamous cell carcinoma
HPV
:   human papillomavirus
MPC
:   metachronous primary cancer
NCCN
:   National Comprehensive Cancer Network
NI-RADS
:   Neck Imaging Reporting and Data System
OS
:   overall survival
PFS
:   progression-free survival
RT
:   radiation therapy" />
<meta name="DC.Contributor" content="Pattana Wangaryattawanich" />
<meta name="DC.Contributor" content="Yoshimi Anzai" />
<meta name="DC.Contributor" content="Carolyn Mead-Harvey" />
<meta name="DC.Contributor" content="Diana Almader-Douglas" />
<meta name="DC.Contributor" content="Tanya J. Rath" />
<meta name="article:published_time" content="2024-11-21" />
<meta name="article:section" content="HEAD AND NECK IMAGING" />
<meta name="citation_title" content="Does Long-Term Surveillance Imaging Improve Survival in Patients Treated for Head and Neck Squamous Cell Carcinoma? A Systematic Review of the Current Evidence" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND:&lt;/h3&gt;
&lt;p&gt;Long-term posttreatment surveillance imaging algorithms for head and neck squamous cell carcinoma are not standardized due to debates over optimal surveillance strategy and efficacy. Consequently, current guidelines do not provide long-term surveillance imaging recommendations beyond 6 months.&lt;/p&gt;&lt;h3&gt;PURPOSE:&lt;/h3&gt;
&lt;p&gt;We performed a systematic review to evaluate the impact of long-term imaging surveillance (ie, imaging beyond 6 months following completion of treatment) on survival in patients treated definitively for head and neck squamous cell carcinoma.&lt;/p&gt;&lt;h3&gt;DATA SOURCES:&lt;/h3&gt;
&lt;p&gt;A search was conducted on PubMed, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and the Web of Science for English literature published between 2003 and 2024 evaluating the impact of long-term surveillance imaging on survival in patients with head and neck squamous cell carcinoma.&lt;/p&gt;&lt;h3&gt;STUDY SELECTION:&lt;/h3&gt;
&lt;p&gt;We screened 718 abstracts and performed full-text review for 95 abstracts, with 2 articles meeting the inclusion criteria. The Risk of Bias in Non-Randomized Studies of Interventions assessment tool was used.&lt;/p&gt;&lt;h3&gt;DATA ANALYSIS:&lt;/h3&gt;
&lt;p&gt;A qualitative assessment without a pooled analysis was performed for the 2 studies meeting inclusion criteria.&lt;/p&gt;&lt;h3&gt;DATA SYNTHESIS:&lt;/h3&gt;
&lt;p&gt;No randomized prospective controlled trials were identified. Two retrospective 2-arm studies were included comparing long-term surveillance imaging with clinical surveillance and were each rated as having a moderate risk of bias. Each study included heterogeneous populations with variable risk profiles and imaging surveillance protocols. Both studies investigated the impact of long-term surveillance imaging on overall survival and came to different conclusions, with 1 study reporting a survival benefit for long-term surveillance imaging with FDG-PET/CT in patients with stage III or IV disease or an oropharyngeal primary tumor and the other study demonstrating no survival benefit.&lt;/p&gt;&lt;h3&gt;LIMITATIONS:&lt;/h3&gt;
&lt;p&gt;Limited heterogeneous retrospective data available precludes definitive conclusions on the impact of long-term surveillance imaging in head and neck squamous cell carcinoma.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;There is insufficient quality evidence regarding the impact of long-term surveillance imaging on survival in patients treated definitively for head and neck squamous cell carcinoma. There is a lack of a standardized definition of long-term surveillance, variable surveillance protocols, and inconsistencies in results reporting, underscoring the need for a prospective multicenter registry assessing outcomes.&lt;/p&gt;" />
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<meta name="citation_author" content="Pattana Wangaryattawanich" />
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<meta name="twitter:title" content="Does Long-Term Surveillance Imaging Improve Survival in Patients Treated for Head and Neck Squamous Cell Carcinoma? A Systematic Review of the Current Evidence" />
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<meta name="twitter:description" content="BACKGROUND: Long-term posttreatment surveillance imaging algorithms for head and neck squamous cell carcinoma are not standardized due to debates over optimal surveillance strategy and efficacy. Consequently, current guidelines do not provide long-term surveillance imaging recommendations beyond 6 months.

PURPOSE: We performed a systematic review to evaluate the impact of long-term imaging surveillance (ie, imaging beyond 6 months following completion of treatment) on survival in patients treated definitively for head and neck squamous cell carcinoma.

DATA SOURCES: A search was conducted on PubMed, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and the Web of Science for English literature published between 2003 and 2024 evaluating the impact of long-term surveillance imaging on survival in patients with head and neck squamous cell carcinoma.

STUDY SELECTION: We screened 718 abstracts and performed full-text review for 95 abstracts, with 2 articles meeting the inclusion criteria. The Risk of Bias in Non-Randomized Studies of Interventions assessment tool was used.

DATA ANALYSIS: A qualitative assessment without a pooled analysis was performed for the 2 studies meeting inclusion criteria.

DATA SYNTHESIS: No randomized prospective controlled trials were identified. Two retrospective 2-arm studies were included comparing long-term surveillance imaging with clinical surveillance and were each rated as having a moderate risk of bias. Each study included heterogeneous populations with variable risk profiles and imaging surveillance protocols. Both studies investigated the impact of long-term surveillance imaging on overall survival and came to different conclusions, with 1 study reporting a survival benefit for long-term surveillance imaging with FDG-PET/CT in patients with stage III or IV disease or an oropharyngeal primary tumor and the other study demonstrating no survival benefit.

LIMITATIONS: Limited heterogeneous retrospective data available precludes definitive conclusions on the impact of long-term surveillance imaging in head and neck squamous cell carcinoma.

CONCLUSIONS: There is insufficient quality evidence regarding the impact of long-term surveillance imaging on survival in patients treated definitively for head and neck squamous cell carcinoma. There is a lack of a standardized definition of long-term surveillance, variable surveillance protocols, and inconsistencies in results reporting, underscoring the need for a prospective multicenter registry assessing outcomes.

CFU
:   clinical follow-up
CR
:   complete response
CRT
:   chemoradiotherapy
HNSCC
:   head and neck squamous cell carcinoma
HPV
:   human papillomavirus
MPC
:   metachronous primary cancer
NCCN
:   National Comprehensive Cancer Network
NI-RADS
:   Neck Imaging Reporting and Data System
OS
:   overall survival
PFS
:   progression-free survival
RT
:   radiation therapy" />
<meta name="og-title" property="og:title" content="Does Long-Term Surveillance Imaging Improve Survival in Patients Treated for Head and Neck Squamous Cell Carcinoma? A Systematic Review of the Current Evidence" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2024/11/21/ajnr.A8392" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND: Long-term posttreatment surveillance imaging algorithms for head and neck squamous cell carcinoma are not standardized due to debates over optimal surveillance strategy and efficacy. Consequently, current guidelines do not provide long-term surveillance imaging recommendations beyond 6 months.

PURPOSE: We performed a systematic review to evaluate the impact of long-term imaging surveillance (ie, imaging beyond 6 months following completion of treatment) on survival in patients treated definitively for head and neck squamous cell carcinoma.

DATA SOURCES: A search was conducted on PubMed, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and the Web of Science for English literature published between 2003 and 2024 evaluating the impact of long-term surveillance imaging on survival in patients with head and neck squamous cell carcinoma.

STUDY SELECTION: We screened 718 abstracts and performed full-text review for 95 abstracts, with 2 articles meeting the inclusion criteria. The Risk of Bias in Non-Randomized Studies of Interventions assessment tool was used.

DATA ANALYSIS: A qualitative assessment without a pooled analysis was performed for the 2 studies meeting inclusion criteria.

DATA SYNTHESIS: No randomized prospective controlled trials were identified. Two retrospective 2-arm studies were included comparing long-term surveillance imaging with clinical surveillance and were each rated as having a moderate risk of bias. Each study included heterogeneous populations with variable risk profiles and imaging surveillance protocols. Both studies investigated the impact of long-term surveillance imaging on overall survival and came to different conclusions, with 1 study reporting a survival benefit for long-term surveillance imaging with FDG-PET/CT in patients with stage III or IV disease or an oropharyngeal primary tumor and the other study demonstrating no survival benefit.

LIMITATIONS: Limited heterogeneous retrospective data available precludes definitive conclusions on the impact of long-term surveillance imaging in head and neck squamous cell carcinoma.

CONCLUSIONS: There is insufficient quality evidence regarding the impact of long-term surveillance imaging on survival in patients treated definitively for head and neck squamous cell carcinoma. There is a lack of a standardized definition of long-term surveillance, variable surveillance protocols, and inconsistencies in results reporting, underscoring the need for a prospective multicenter registry assessing outcomes.

CFU
:   clinical follow-up
CR
:   complete response
CRT
:   chemoradiotherapy
HNSCC
:   head and neck squamous cell carcinoma
HPV
:   human papillomavirus
MPC
:   metachronous primary cancer
NCCN
:   National Comprehensive Cancer Network
NI-RADS
:   Neck Imaging Reporting and Data System
OS
:   overall survival
PFS
:   progression-free survival
RT
:   radiation therapy" />
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      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">HEAD AND NECK IMAGING</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Does Long-Term Surveillance Imaging Improve Survival in Patients Treated for Head and Neck Squamous Cell Carcinoma? A Systematic Review of the Current Evidence</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Pattana Wangaryattawanich</span>, <span class="highwire-citation-author" data-delta="1">Yoshimi Anzai</span>, <span class="highwire-citation-author" data-delta="2">Carolyn Mead-Harvey</span>, <span class="highwire-citation-author" data-delta="3">Diana Almader-Douglas</span> and <span class="highwire-citation-author" data-delta="4">Tanya J. Rath</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2024,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8392 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-111920--61389327500" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Pattana Wangaryattawanich </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (P.W.), University of Washington School of Medicine, Seattle, Washington</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Pattana%2BWangaryattawanich%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wangaryattawanich%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li 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Trials and Biostatistics, Mayo Clinic, Phoenix, Arizona.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Carolyn%2BMead-Harvey%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mead-Harvey%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3ACarolyn%2BMead-Harvey%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-6887-0430" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Carolyn Mead-Harvey</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Diana Almader-Douglas </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Mayo Clinic Libraries (D.A.-D.), Mayo Clinic, Phoenix, Arizona</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Diana%2BAlmader-Douglas%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Almader-Douglas%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ADiana%2BAlmader-Douglas%2B" 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Rath </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Radiology (T.J.R.), Mayo Clinic, Phoenix, Arizona</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Tanya%2BJ.%2BRath%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rath%20TJ&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3ATanya%2BJ.%2BRath%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-0359-7055" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Tanya J. 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