Pain as sign of recurrent disease in head and neck squamous cell carcinoma.

Abstract

The role of pain in head and neck cancer is seldom addressed. This retrospective study examined in a group of 190 curatively treated patients to what extent pain complaints should be considered to be the first sign of recurrent disease. The research population exists of 95 patients with a recurrent head and neck carcinoma and control group matched for age, gender, primary tumor, and duration of follow-up. Of the patients with proven recurrent disease, 70% reported pain complaints as the first symptom. In 35% of these cases, the complaints concerned referred pain, whereas in 65% localized pain complaints in the head and neck were registered. The median interval between reporting localized pain complaints and histologic confirmation of recurrence was 4 months. In the case of referred pain, this delay was 2.5 months. No statistically significant correlation between pain complaints and site of recurrence could be demonstrated. Only 2% of the control group reported pain complaints. This study confirms that each pain complaint after intentional curative treatment should be regarded as a warning sign. Recurrence of disease without preceding pain complaints (30%) emphasizes the importance of a thorough follow-up.