Loco-regional recurrence after surgical treatment of XXXX : Proposals for follow-up imaging based on literature, national guidelines and institutional experience.

@entity1 @entity135 @entity5 @entity957 @entity3
UNASSIGNED: The recurrence rate following the treatment of @entity957 ( @entity957 ) by primary surgery is about 10%-26%. The earliest possible diagnosis of @entity5 , recurrence of @entity5 , and subsequent @entity3 is essential for an improvement of the overall survival and of the survival period for affected @entity1 . No international consensus exists for a post-therapeutic surveillance schedule for OSCCs. Based on a review of the literature, existing guidelines, and our institutional experience, we have established an algorithm for the follow-up of these @entity1 regarding the timing and techniques of postoperative imaging. We recommend a follow-up interval of 6 weeks during the first half-year after discharge from hospital by single clinical and alternating clinical check-ups combined with computed tomography (CT) or magnetic resonance imaging (MRI), followed by an interval of 3 months in the second half-year, with clinical and radiological check-ups. In year 2, we recommend a follow-up interval of 3 months with single clinical and alternating clinical check-ups combined with CT or MRI. In year 3, we recommend screening every 6 months, both  clinically and via imaging, because of the decreased risk of recurrence. From year 5 onwards, our recommendation is a clinical and imaging-based examination every 6-12 months, depending on @entity1 risk factors and disease progression. Four standard imaging techniques, namely positron emission tomography (PET), CT, MRI, and ultrasound (US), are discussed concerning their range of application, sensitivity, and specificity. Furthermore, the technical aspects of our institutional protocols are described in detail. In highly frequented @entity135 centres, PET and US are of secondary importance, since CT and MRI are nowadays highly efficient tools in primary diagnostic and post-therapeutic surveillance.
