How effective is our current follow-up for patients with hypopharyngeal carcinoma?

BACKGROUND: The study aimed to evaluate the diagnostic efficacy of routine follow-up in detecting recurrent disease in hypopharyngeal carcinoma. METHODS: Data from 76 patients with a total of 620 follow-up visits, 367 radiological studies, and 126 panendoscopies were retrospectively assessed regarding the diagnosis of recurrent disease based on the results of (I) radiological studies, (II) clinical examinations, and (III) clinical symptoms. RESULTS: All locally relapsed patients became symptomatic, and new onset of dysphagia (p < 0.001) was the most frequent complaint. The sensitivity for detecting local recurrences was 100% for both patients' symptom assessments and clinical examinations. The highest overall accuracy was found for clinical examinations (93.4%), followed by symptom assessments (80.5%), and radiological studies (73.8%). The risk of false positive radiological reports and subsequent panendoscopies was 2.2 times higher after previous radiotherapy (32.0% vs. 14.6%; p < 0.001). CONCLUSION: Symptom assessments and clinical examinations are highly efficient for detection of local failures.