{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T16:44:06Z","timestamp":1782233046029,"version":"3.54.5"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To report the incidence of locoregional recurrence in head and neck cancer (HNC) patients under surveillance following treatment undergoing symptom\u2010based remote assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A 16\u2010week multicentre prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>UK ENT departments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>HNC patients under surveillance following treatment undergoing symptom\u2010based telephone assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Incidence of locoregional recurrent HNC after minimum 6\u2010month follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data for 1078 cases were submitted by 16 centres, with follow\u2010up data completed in 98.9% (<jats:italic>n<\/jats:italic>\u00a0=\u00a01066). Following telephone consultation, 83.7% of referrals had their face\u2010to\u2010face appointments deferred (<jats:italic>n<\/jats:italic>\u00a0=\u00a0897\/1072). New symptoms were reported by 11.6% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0124\/1072) at telephone assessment; 72.6% (<jats:italic>n<\/jats:italic>\u00a0=\u00a090\/124) of this group were called for urgent assessments, of whom 48.9% (<jats:italic>n<\/jats:italic>\u00a0=\u00a044\/90) came directly for imaging without preceding clinical review. The sensitivity and specificity for new symptoms as an indicator of cancer recurrence were 35.3% and 89.4%, respectively, with a negative predictive value of 99.7% (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.002). Locoregional cancer identification rates after a minimum of 6\u00a0months of further monitoring, when correlated with time since treatment, were 6.0% (<jats:italic>n<\/jats:italic>\u00a0=\u00a014\/233) &lt;1\u00a0year; 2.1% (<jats:italic>n<\/jats:italic>\u00a0=\u00a016\/747) between 1 and 5\u2009years; and 4.3% (<jats:italic>n<\/jats:italic>\u00a0=\u00a04\/92) for those &gt;5\u2009years since treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Telephone assessment, using patient\u2010reported symptoms, to identify recurrent locoregional HNC was widely adopted during the initial peak of the COVID\u201019 pandemic in the United Kingdom. The majority of patients had no face\u2010to\u2010face reviews or investigations. New symptoms were significantly associated with the identification of locoregional recurrent cancers with a high specificity, but a low sensitivity may limit symptom assessment being used as the sole surveillance method.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13948","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T07:58:50Z","timestamp":1653897530000},"page":"561-567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Symptom\u2010based remote assessment in post\u2010treatment head and neck cancer surveillance: A prospective national study"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3744-736X","authenticated-orcid":false,"given":"Henry","family":"Zhang","sequence":"first","affiliation":[{"name":"Head and Neck Unit Royal Marsden Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6591-5119","authenticated-orcid":false,"given":"John C.","family":"Hardman","sequence":"additional","affiliation":[{"name":"Head and Neck Unit Royal Marsden Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2828-2874","authenticated-orcid":false,"given":"Theofano","family":"Tikka","sequence":"additional","affiliation":[{"name":"Head and Neck Unit Royal Marsden Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Nankivell","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Studies and Education (InHANSE) University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisham","family":"Mehanna","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Studies and Education (InHANSE) University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinidh","family":"Paleri","sequence":"additional","affiliation":[{"name":"Head and Neck Unit Royal Marsden Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"ENT UK, BAHNO, INTEGRATE (The UK ENT Trainee Research Network)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2017.03.012"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21343"},{"key":"e_1_2_11_4_1","article-title":"Post\u2010treatment head and neck cancer care: National audit and analysis of current practice in the United Kingdom","volume":"46","author":"Ellis M","year":"2021","journal-title":"Clin Otolaryngol"},{"key":"e_1_2_11_5_1","article-title":"Admission avoidance in tonsillitis and peritonsillar abscess: a prospective national audit during the initial peak of the COVID\u201019 pandemic","volume":"46","author":"INTEGRATE (The UKENT Research Trainee Network)","year":"2021","journal-title":"Clin Otolaryngol"},{"key":"e_1_2_11_6_1","article-title":"Admission avoidance in acute epistaxis: a prospective national audit during the initial peak of the COVID\u201019 pandemic","volume":"46","author":"INTEGRATE (The UKENT Research Trainee Network)","year":"2021","journal-title":"Clin Otolaryngol"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30334-X"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33800"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13511"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26219"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116000645"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2010.05.016"},{"key":"e_1_2_11_13_1","first-page":"2849","article-title":"Self\u2010reported symptoms to monitor recurrent head and neck cancer\u2010analysis of 1,678 cases","volume":"36","author":"Boysen ME","year":"2016","journal-title":"Anticancer Res"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2009.02033.x"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.668"},{"key":"e_1_2_11_16_1","unstructured":"ENT UK.ENTUK Guidelines for changes in ENT during COVID\u201019 Pandemic [Internet]. British Association of Otorhinolaryngology\u2014Head and Neck Surgery.2020[cited 2021 Aug 27]. Available from:https:\/\/www.entuk.org\/entuk-guidelines-changes-ent-during-covid-19-pandemic"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta21170"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.11.009"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20790"},{"key":"e_1_2_11_20_1","unstructured":"NIHR Funding and Awards.PET\u2010CT guided symptom\u2010based patient\u2010initiated surveillance versus clinical follow\u2010up in advanced head neck cancer (PET NECK 2) [Internet]. NIHR Funding and Awards.2020. 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