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Chest Scan Crucial in Head and Neck Cancer Follow-Up

High-risk patients should be scanned every six months for first two years after surgery

MONDAY, Oct. 20 (HealthDay News) -- High-risk head and neck squamous cell carcinoma patients should receive postoperative chest computed tomography (CT) every six months during two years of follow-up, according to research published in the October issue of the Archives of Otolaryngology -- Head & Neck Surgery.

Yen-Bin Hsu, M.D., of the Taipei Veterans General Hospital in Taipei, Taiwan, and colleagues conducted a study of 192 head and neck squamous cell carcinoma patients who underwent 270 screening chest CT scans over a period of 42 months' follow-up.

In all, 79 (29.3 percent) of the scans had abnormal results, and the rate was higher, at 44.2 percent, in the follow-up cases group, than in the new cases group, at 14.2 percent, the research showed. There were 15 indeterminate scans, of which 10 (66.7 percent) showed disease progression on subsequent scans, which changed the patients' diagnosis to malignant neoplasm of the lung, the investigators report. Initial N2 or N3 disease, stage IV disease, recurrent disease and distant metastasis to another site were all predictive of development of lung cancer, the researchers note.

"Chest CT is recommended for high-risk patients, especially every six months for the first two years during the follow-up period, although its role is controversial for patients newly diagnosed as having head and neck squamous cell carcinoma," the authors write. "For patients with indeterminate small solitary pulmonary nodules, aggressive evaluation and management are imperative because of the high rate of a malignant neoplasm of the lung."

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