How surgeon age affects posttreatment surveillance strategies for upper aerodigestive tract cancer patients

Purpose: Strategies for the surveillance of patients with upper aerodigesti ve tract (UADT) epidermoid cancer after potentially curative treatment are not uniform, and the most suitable regimen remains unknown. We investigated the effect of surgeon age on follow-up strategy. Materials and Methods: The 824 members of the Society of Head and Neck Surg eons (SHNS) and the 522 members of the American Society for Head and Neck S urgery (ASHNS) who were not members of the SHNS were surveyed using a custo m-designed questionnaire to measure how these surgical experts performed fo llow-up on patients with UADT cancer. Subjects were asked how often they us ed 14 specific follow-up modalities for patients with resectable UADT cance r during years 1 to 5 after potentially curative primary treatment. Repeate d-measures analysis of variance was used to compare practice patterns by su rgeon age, as well as by tumor, node, metastasis (TNM) stage and year posts urgery. Results: Responses from 199 SHNS members (24%) and 221 ASHNS members (42%) were considered assessable. Strategies were highly correlated across TNM st ages and years postsurgery for most of the 14 modalities. Mean follow-up in tensity differed significantly by surgeon age only for bone scan and liver function tests. Although statistically significant, the differences in surv eillance strategies among age groups were clinically small. Conclusion: Surveillance practice patterns of surgeons caring for patients after treatment for UADT cancer do not vary substantially with practitioner age. Postgraduate education is a plausible mechanism for this homogenizati on of practitioner behavior. (Am J Otolaryngol 1999;20:217-222. Copyright ( C) 1999 by W.B. Saunders Company).