HOW TUMOR STAGE AFFECTS SURGEONS SURVEILLANCE STRATEGIES AFTER SURGERY FOR CARCINOMA OF THE UPPER AERODIGESTIVE TRACT

BACKGROUND. The factors that influence decision-making among surgeons are not well understood. The authors evaluated how tumor stage in othe rwise healthy patients subjected to potentially curative surgery for u pper aerodigestive tract (UADT) epidermoid carcinoma affects the self- reported follow-up strategies employed by practicing surgeons. METHODS . Hypothetical patient profiles and a detailed questionnaire based on these profiles were mailed to the 824 members of the Society of Head a nd Neck Surgeons (SHNS) and the 522 members of the American Society fo r Read and Neck Surgery who were not members of SHNS. The effect of TN M stage on the surveillance strategies chosen by the respondents was a nalyzed. RESULTS. Ten of the 14 most commonly employed surveillance mo dalities were ordered significantly more frequently with increasing TN M stage. This effect persisted through 5 years of follow-up, but the d ifferences across stages were small. Only 30% of respondents modified their strategies according to the patient's TNM stage. CONCLUSIONS. Mo st surgeons performing surveillance after potentially curative surgery in otherwise healthy patients with UADT carcinoma use the same follow -up strategy irrespective of TNM stage. These data permit rational des ign of a randomized clinical trial of two alternate follow-up plans. ( C) 1998 American Cancer Society.