{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T21:50:17Z","timestamp":1780437017462,"version":"3.54.1"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Patients with head and neck squamous cell carcinoma (HNSCC) have a significant risk of locoregional recurrence within the first 2 years, with approximately two-thirds of patients experiencing such recurrence. While early recurrence detection may be associated with improved patient outcomes, the association of such detection with survival remains uncertain.<\/jats:p><\/jats:sec>Objective<\/jats:title>To investigate the association of an intensive posttreatment follow-up strategy using 18<\/jats:sup>F-fludeoxyglucose\u2013positron emission tomography with computed tomography (18<\/jats:sup>FDG-PET\/CT) with survival among patients with HNSCC.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This case-control study was conducted among patients treated at 1 of 3 locations in Brest, France (University Hospital, Military Hospital, or Pasteur Clinic). The statistical analysis was conducted from January to June 2023. All adults with histologically proven HNSCC who were treated with curative intent between January 1, 2006, and December 31, 2019, and achieved a complete response on imaging at 3 to 6 months were included. They had a minimum of 3 years of follow-up.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Patients undergoing an intensive posttreatment follow-up strategy had 18<\/jats:sup>FDG-PET\/CT (PET\/CT group) at months 12, 24, and 36, chosen at the discretion of ear, nose, and throat surgeons.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Overall survival (OS) at 3 years.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 782 patients with HNSCC (642 males [82.1%]; median [IQR] age, 61 [56-68] years), 497 patients had 18<\/jats:sup>FDG-PET\/CT during follow-up and 285 patients had conventional follow-up (CFU group). Cox regression analysis showed an association between undergoing 18<\/jats:sup>FDG-PET\/CT and lower risk of death (odds ratio, 0.71; 95% CI, 0.57-0.88; P<\/jats:italic>\u2009=\u2009.002) after adjustment for covariates (age, sex, comorbidities, primary location, stage, surgeon, year of treatment, and treatment). The mean (SD) 3-year OS was significantly better in the PET\/CT vs CFU group (72.5% [2.0%] vs 64.3% [2.9%]; P<\/jats:italic>\u2009=\u2009.002). Analysis based on American Joint Committee on Cancer stage showed significantly better mean (SD) 3-year OS for advanced stages III and IV in the PET\/CT group (373 patients) vs CFU group (180 patients; 68.5% [2.4%] vs 55.4% [3.8%]; P<\/jats:italic>\u2009&amp;lt;\u2009.001), while no significant difference was observed between patients with stage I or II HNSCC. Analysis based on primary tumor site revealed significantly longer mean (SD) 3-year OS for oropharyngeal tumor in the PET\/CT group (176 patients) than the CFU group (100 patients; 69.9% [3.5%] vs 60.5% [5.0%]; P<\/jats:italic>\u2009=\u2009.04).<\/jats:p><\/jats:sec>Conclusions and relevance<\/jats:title>This case-control study found that use of 18<\/jats:sup>FDG-PET\/CT in the standard annual CFU of HNSCC was associated with a 3-year survival benefit, with a larger benefit for patients with advanced initial tumor stage (III-IV) and oropharyngeal disease.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.26654","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T15:00:59Z","timestamp":1690902059000},"page":"e2326654","source":"Crossref","is-referenced-by-count":13,"title":["An Intensive 18<\/sup>F-Fludeoxyglucose\u2013Positron Emission Tomography With Computed Tomography\u2013Based Strategy of Follow-Up in Patients Treated for Head and Neck Squamous Cell Carcinoma Who Are Clinically Asymptomatic"],"prefix":"10.1001","volume":"6","author":[{"given":"Jean-Christophe","family":"Lecl\u00e8re","sequence":"first","affiliation":[{"name":"Head and Neck Surgery Department, University Hospital of Brest, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Cl\u00e9ment","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Department, University Hospital of Brest, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Le Pennec","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Department, University Hospital of Brest, Brest, France"},{"name":"UMR Inserm 1304 GETBO, University of Western Brittany, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clementine","family":"Maheo","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Department, University Hospital of Brest, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy M.","family":"Gujral","sequence":"additional","affiliation":[{"name":"Clinical Oncology Department, Imperial College Healthcare National Health Service Trust, Charing Cross Hospital, London, United Kingdom"},{"name":"Department of Cancer and Surgery, Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Schick","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, University Hospital of Brest, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gr\u00e9goire","family":"Le Gal","sequence":"additional","affiliation":[{"name":"Clinical Investigation Center CIC 1412, University Hospital of Brest, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remi","family":"Marianowski","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Department, University Hospital of Brest, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Yves","family":"Salaun","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Department, University Hospital of Brest, Brest, France"},{"name":"UMR Inserm 1304 GETBO, University of Western Brittany, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronan","family":"Abgral","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Department, University Hospital of Brest, Brest, France"},{"name":"UMR Inserm 1304 GETBO, University of Western Brittany, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,8,1]]},"reference":[{"issue":"1","key":"zoi230770r1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21332","article-title":"Cancer statistics, 2016.","volume":"66","author":"Siegel","year":"2016","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"zoi230770r2","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1056\/NEJMoa0912217","article-title":"Human papillomavirus and survival of patients with oropharyngeal cancer.","volume":"363","author":"Ang","year":"2010","journal-title":"N Engl J Med"},{"issue":"4","key":"zoi230770r3","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1001\/jamaoncol.2016.5688","article-title":"Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study.","volume":"3","author":"Fitzmaurice","year":"2017","journal-title":"JAMA Oncol"},{"issue":"7","key":"zoi230770r4","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.3174\/ajnr.A6614","article-title":"Posttreatment imaging in patients with head and neck cancer without clinical evidence of recurrence: should surveillance imaging extend beyond 6 months?","volume":"41","author":"Gore","year":"2020","journal-title":"AJNR Am J Neuroradiol"},{"issue":"3","key":"zoi230770r5","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/S0720-048X(99)00120-5","article-title":"Head and neck tumors: imaging recurrent tumor and post-therapeutic changes with CT and MRI.","volume":"33","author":"Lell","year":"2000","journal-title":"Eur J Radiol"},{"issue":"3","key":"zoi230770r7","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1016\/j.bulcan.2019.01.002","article-title":"Actualisation des recommandations de bonne pratique clinique pour l\u2019utilisation de la TEP en canc\u00e9rologie. Update of the recommendations of good clinical practice for the use of PET in oncology.","volume":"106","author":"Sala\u00fcn","year":"2019","journal-title":"Bull Cancer"},{"issue":"1","key":"zoi230770r8","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1007\/s00259-019-04553-8","article-title":"Good clinical practice recommendations for the use of PET\/CT in oncology.","volume":"47","author":"Sala\u00fcn","year":"2020","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"1","key":"zoi230770r9","doi-asserted-by":"publisher","first-page":"24","DOI":"10.2967\/jnumed.108.055806","article-title":"Does 18F-FDG PET\/CT improve the detection of posttreatment recurrence of head and neck squamous cell carcinoma in patients negative for disease on clinical follow-up?","volume":"50","author":"Abgral","year":"2009","journal-title":"J Nucl Med"},{"issue":"1","key":"zoi230770r10","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1007\/s00259-014-2889-1","article-title":"Diagnostic performance of FDG PET\/CT to detect subclinical HNSCC recurrence 6 months after the end of treatment.","volume":"42","author":"Robin","year":"2015","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"3","key":"zoi230770r11","doi-asserted-by":"publisher","first-page":"629","DOI":"10.2214\/AJR.14.14166","article-title":"Diagnostic accuracy of follow-up FDG PET or PET\/CT in patients with head and neck cancer after definitive treatment: a systematic review and meta-analysis.","volume":"205","author":"Sheikhbahaei","year":"2015","journal-title":"AJR Am J Roentgenol"},{"issue":"6","key":"zoi230770r12","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1007\/s00259-018-3978-3","article-title":"FDG-PET\/CT for treatment response assessment in head and neck squamous cell carcinoma: a systematic review and meta-analysis of diagnostic performance.","volume":"45","author":"Helsen","year":"2018","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"11","key":"zoi230770r13","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.1007\/s00259-011-1893-y","article-title":"Diagnostic performance of post-treatment FDG PET or FDG PET\/CT imaging in head and neck cancer: a systematic review and meta-analysis.","volume":"38","author":"Gupta","year":"2011","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"3","key":"zoi230770r14","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1111\/j.1749-4486.2008.01688.x","article-title":"A systematic review and meta-analysis of the role of positron emission tomography in the follow up of head and neck squamous cell carcinoma following radiotherapy or chemoradiotherapy.","volume":"33","author":"Isles","year":"2008","journal-title":"Clin Otolaryngol"},{"key":"zoi230770r15","doi-asserted-by":"publisher","DOI":"10.1155\/2009\/208725","article-title":"Clinical applications of FDG PET and PET\/CT in head and neck cancer.","volume":"2009","author":"Al-Ibraheem","year":"2009","journal-title":"J Oncol"},{"key":"zoi230770r16","doi-asserted-by":"publisher","first-page":"273","DOI":"10.3389\/fmed.2020.00273","article-title":"Integration of 18-FDG PET\/CT in the initial work-up to stage head and neck cancer: prognostic significance and impact on therapeutic decision making.","volume":"7","author":"Leclere","year":"2020","journal-title":"Front Med (Lausanne)"},{"key":"zoi230770r17","doi-asserted-by":"publisher","first-page":"688","DOI":"10.3389\/fonc.2020.00688","article-title":"Follow-up of head and neck cancer survivors: tipping the balance of intensity.","volume":"10","author":"Szturz","year":"2020","journal-title":"Front Oncol"},{"issue":"7","key":"zoi230770r18","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1001\/jamaoto.2021.0835","article-title":"Costs associated with imaging surveillance after treatment for head and neck cancer.","volume":"147","author":"Nocon","year":"2021","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"15","key":"zoi230770r19","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.1056\/NEJMoa1514493","article-title":"PET-CT surveillance versus neck dissection in advanced head and neck cancer.","volume":"374","author":"Mehanna","year":"2016","journal-title":"N Engl J Med"},{"issue":"6","key":"zoi230770r22","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1245\/s10434-010-0985-4","article-title":"The American Joint Committee on Cancer: the 7th edition of the AJCC Cancer Staging Manual and the future of TNM.","volume":"17","author":"Edge","year":"2010","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"zoi230770r23","doi-asserted-by":"publisher","first-page":"93","DOI":"10.3322\/caac.21388","article-title":"The Eighth Edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging.","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J Clin"},{"issue":"7","key":"zoi230770r24","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1002\/cncr.27892","article-title":"Impact of positron emission tomography\/computed tomography surveillance at 12 and 24 months for detecting head and neck cancer recurrence.","volume":"119","author":"Ho","year":"2013","journal-title":"Cancer"},{"issue":"12","key":"zoi230770r25","doi-asserted-by":"publisher","first-page":"2973","DOI":"10.1038\/bjc.2013.668","article-title":"(18)F-FDG PET\/CT surveillance at 3-6 and 12 months for detection of recurrence and second primary cancer in patients with head and neck squamous cell carcinoma.","volume":"109","author":"Kim","year":"2013","journal-title":"Br J Cancer"},{"issue":"9","key":"zoi230770r26","doi-asserted-by":"publisher","first-page":"2161","DOI":"10.1002\/lary.v123.9","article-title":"PET-CT and the detection of the asymptomatic recurrence or second primary lesions in the treated head and neck cancer patient.","volume":"123","author":"Dunsky","year":"2013","journal-title":"Laryngoscope"},{"issue":"7","key":"zoi230770r27","doi-asserted-by":"publisher","first-page":"1512","DOI":"10.1002\/lary.v122.7","article-title":"Temporal patterns of head and neck squamous cell carcinoma recurrence with positron-emission tomography\/computed tomography monitoring.","volume":"122","author":"Beswick","year":"2012","journal-title":"Laryngoscope"},{"issue":"22","key":"zoi230770r28","doi-asserted-by":"publisher","first-page":"5843","DOI":"10.3390\/cancers13225843","article-title":"Surveillance for patients with oral squamous cell carcinoma after complete surgical resection as primary treatment: a single-center retrospective cohort study.","volume":"13","author":"Fukumoto","year":"2021","journal-title":"Cancers (Basel)"},{"issue":"3","key":"zoi230770r29","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/0895-4356(95)00042-9","article-title":"A follow-up study of determinants of second tumor and metastasis among subjects with cancer of the oral cavity, pharynx, and larynx.","volume":"49","author":"Barbone","year":"1996","journal-title":"J Clin Epidemiol"},{"issue":"12","key":"zoi230770r30","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1007\/s10654-018-0409-5","article-title":"Tumour stage and gender predict recurrence and second primary malignancies in head and neck cancer: a multicentre study within the INHANCE consortium.","volume":"33","author":"Leoncini","year":"2018","journal-title":"Eur J Epidemiol"},{"issue":"3","key":"zoi230770r31","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/(SICI)1097-0347(199905)21:3<204::AID-HED4>3.0.CO;2-7","article-title":"Second neoplasm in patients with head and neck cancer.","volume":"21","author":"Le\u00f3n","year":"1999","journal-title":"Head Neck"},{"issue":"1","key":"zoi230770r32","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/ecc.12084","article-title":"Secondary primary cancer in patients with head and neck carcinoma: the differences among hypopharyngeal, laryngeal, and other sites of head and neck cancer.","volume":"23","author":"Liu","year":"2014","journal-title":"Eur J Cancer Care (Engl)"},{"issue":"5","key":"zoi230770r33","doi-asserted-by":"crossref","DOI":"10.1111\/ecc.13255","article-title":"Occurrence of metachronous second primary cancer in head and neck cancer survivors: a systematic review and meta-analysis of the literature.","volume":"29","author":"Hoxhaj","year":"2020","journal-title":"Eur J Cancer Care (Engl)"},{"issue":"3","key":"zoi230770r34","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.oraloncology.2008.05.024","article-title":"FDG-PET and detection of distant metastases and simultaneous tumors in head and neck squamous cell carcinoma: a comparison with chest radiography and chest CT.","volume":"45","author":"Krabbe","year":"2009","journal-title":"Oral Oncol"},{"key":"zoi230770r6","unstructured":"National Comprehensive Cancer Network. NCCN guidelines head and neck cancers. Accessed February 3, 2023. https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=1&id=1437"},{"key":"zoi230770r20","unstructured":"Gustave Roussy, Cancer Campus. Multicentric comparative study between a conventional and an intensive follow up strategy after treatment of a head and neck squamous cell carcinoma (SURVEILL'ORL). ClinicalTrials.gov. Accessed February 2, 2023. https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03519048"},{"key":"zoi230770r21","unstructured":"Fondazione IRCCS Istituto Nazionale dei Tumori. Health and economic outcomes of two different follow up strategies in effectively cured advanced head and neck cancer (HETeCo). ClinicalTrials.gov. Accessed February 2, 2023. https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02262221"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2807804\/leclre_2023_oi_230770_1689968928.51114.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T15:01:06Z","timestamp":1690902066000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2807804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,1]]},"references-count":34,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.26654","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,1]]}}}