Upper Aerodigestive Tract Cancer (UADT)

Reference/Study Question

Methods

How tumor stage affects surgeons’ surveillance strategies after surgery for carcinoma of the upper aerodigestive tract (Johnson et al., 1998)

How surgeon age affects post-treatment surveillance strategies for upper aerodigestive tract cancer patients (Clark et al., 1999)

Surgical decision making in upper aerodigestive tract cancer patient follow-up (Virgo et al., 2002)

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Does tumor stage and surgeon age affect surveillance practices? Do clinical beliefs explain follow-up practices?

Method: Mail survey of head and neck surgeons.

Sample: 824 members of the Society of Head and Neck Surgeons (SHNS) and 522 members of the American Society for Head and Neck Surgery (ASHNS) who were not members of the SHNS were surveyed by mail in 1996 on use of 14 follow-up modalities for patients with resectable UADT cancer during years 1 to 5 after potentially curative primary treatment.

  1. Office visit

  2. CBC

  3. Serum electrolytes (calcium level)

  4. Serum liver function tests

  5. Serum tumor marker measurement

  6. Thyroid function tests

  7. Chest X ray

  8. Bone scan

  9. Chest CT

  10. Head and neck CT

  11. Head and neck MRI

  12. Sonogram of the head and neck

  13. Flexible esophagoscopy

  14. Flexible bronchoscopy

RR = 24% (199/824) for SHNS and 42% (221/522) for ASHNS.

 

Statistical methods: Repeated-measures analysis of variance. The relationship between clinical beliefs and test ordering practices was examined using Poisson and negative binomial regression analysis.

 

Explanatory variables: TNM stage, year post-surgery, and surgeon age clinical beliefs.



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