Post-treatment monitoring of salivary gland cancer: REFCOR recommendations by the formal consensus method - 29/11/23

Doi : 10.1016/j.anorl.2023.11.003

E. Chabrillac ^a,⁎ , S. Vergez ^a,^b, B. Barry ^c, F. Jegoux ^d, B. Verillaud ^e, N. Pham Dang ^f, B. Baujat ^g, N. Fakhry ^h
^a Département de chirurgie, institut universitaire du cancer Toulouse – Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France
^b Département de chirurgie ORL et cervico-faciale, CHU de Toulouse-Larrey, université Toulouse III Paul-Sabatier, Toulouse, France
^c Département d’ORL et chirurgie cervico-faciale, hôpital Bichat, AP–HP, Paris, France
^d Département d’ORL et chirurgie cervico-faciale, CHU de Rennes, Rennes, France
^e Département d’ORL et de chirurgie cervico-faciale, hôpital Lariboisière, AP–HP, Inserm U1141, université Paris Cité, Paris, France
^f Service de chirurgie maxillo-faciale, université Clermont-Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol, 63000 Clermont-Ferrand, France
^g Département d’ORL et chirurgie cervico-faciale, Sorbonne université, hôpital Tenon, AP–HP, Paris, France
^h Département d’ORL et chirurgie cervico-faciale, hôpital La Conception, AP–HM, Marseille, France

^*Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 29 November 2023

Abstract

Objective

To determine the frequency and modality of post-treatment monitoring of primary salivary gland cancer.

Material and methods

The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group who drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method.

Results

Clinical monitoring should be adapted to the risk of recurrence: initially every 3 months and progressively spaced out, becoming annual after 5 years. Post-treatment head and neck and chest imaging is recommended at 3 months. Local and regional monitoring can then be carried out yearly or twice yearly with contrast-enhanced head and neck imaging. An annual chest CT scan is recommended for high-grade tumors. For lesions at high risk of late recurrence, very prolonged annual surveillance (up to 15 years) is recommended, including screening for pulmonary metastases.

Conclusion

Given the wide range of malignant salivary gland tumors, the modalities and frequency of post-treatment monitoring must be adapted to the expected course of the disease.

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Keywords : Salivary gland cancer, Post-treatment monitoring, Major salivary gland, Minor salivary gland