Laryngeal cancer

The majority of recurrences occur in the first 2 years after initial treatment.[1]National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: head and neck cancers [internet publication]. https://www.nccn.org/professionals/physician_gls/default.aspx ​ Patients require regular surveillance for cancer recurrence for 5 years after treatment. Patients may undergo clinical exam with flexible fiberoptic laryngoscopy every 1-3 months for the first year after treatment, every 2-6 months for the second year, every 4-8 months for the third, fourth, and fifth years, and every year thereafter.[1]National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: head and neck cancers [internet publication]. https://www.nccn.org/professionals/physician_gls/default.aspx ​ Continued surveillance may not be needed after 5 years of follow-up.

Physical exam is considered the best measure to assess long-term recurrence. Patients with suspicious lesions or neck masses undergo repeat CT imaging and biopsy. Many treatment centers obtain post-treatment PET/CT scans to assess for response to therapy, but this is not considered mandatory. Induced fluorescence endoscopy may be useful for the detection of recurrent disease.[32]Kraft M, Betz CS, Leunig A, et al. Value of fluorescence endoscopy for the early diagnosis of laryngeal cancer and its precursor lesions. Head & Neck. 2011 Jul;33(7):941-8. http://www.ncbi.nlm.nih.gov/pubmed/21674669?tool=bestpractice.com No surveillance imaging studies are consistently recommended for routine surveillance.