Definition of locally recurrent head and neck squamous cell carcinoma: a systematic review and proposal for the Odense-Birmingham definition.

ABSTRACT

PURPOSE: The objectives of this study were (1) to systematically review current definitions of head and neck squamous cell carcinoma (HNSCC) recurrence and (2) to propose a definition of locally recurrent HNSCC. METHODS: A systematic literature review was performed according to the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' statement in Medline, Embase, and Cochrane databases guided by the study question "What is the definition of local recurrence for patients with HNSCC?". All retrieved studies were reviewed and qualitatively analyzed. RESULTS: The systematic literature search resulted in 3467 publications after removal of duplicates. Forty studies were examined as full text, and a total of five were found suitable for inclusion. All five included studies dealt with definitions of second primary HNSCC and were based on the Warren and Gates Criteria; (1) each of the tumors are malignant, (2) each must be distinct, and (3) the probability of one being a metastasis of the other must be excluded. Each of the included studies added specific anatomical and/or temporal separation measures to the criteria of second primary HNSCC. We propose the definition of locally recurrent HNSCC to be (1) Same anatomical subsite or adjacent subsite within 3 cm of the primary lesion, (2) time-interval no more than 3 years (from completed treatment of the primary lesion), and (3) same p16-status for oropharyngeal carcinomas. CONCLUSIONS: No uniform definition of locally recurrent HNSCC currently exists. We propose the Odense-Birmingham definition based on the anatomical subsite combined with a specific measurable distance and a temporal separation of three years.