Adherence with National Comprehensive Cancer Network posttreatment surveillance guidelines in patients with head and neck cancer

Background: Surveillance in head and neck cancer (HNC) is essential to detect recurrent or new lesions and to optimize function. This study describes drivers of surveillance adherence in patients with HNC and its effect on prognosis. Methods: Adherence with surveillance of HNC patients was determined using the National Comprehensive Cancer Network HNC guidelines. Logistic regression and Cox proportional hazards models were used to determine predictors of adherence and overall survival (OS). Results: Results showed that 110 of 221 patients (50.2%) were adherent with surveillance. Distance from the treatment center was the only significant association. Adherence was not associated with OS following multivariate adjustment (adjusted hazard ratio [aHR] = 0.68, 95% confidence interval [CI] = 0.43-1.09). However, 5-10 years after treatment completion, adherence was an independent predictor of survival (aHR = 0.24, 95% CI = 0.09-0.61). Conclusion: Adherence with surveillance is important in improving survival in patients with HNC, especially in the long term.