[Prevention in oncological follow-up].

Abstract

Background: In light of increasing remission and 5‑year survival rates, prevention-orientated follow-up care of patients after head and neck cancer is becoming increasingly relevant. In addition to oncologic surveillance, measures aimed at preventing recurrent, second primaries, and long-term functional sequalae are gaining importance.

Objective: The aim of this review is to analyze preventive strategies in the follow-up care of patients with head and neck cancer.

Materials and methods: A narrative literature review was conducted in PubMed, focusing on prevention-oriented follow-up care in head and neck cancer. In addition, national and international guidelines (Association of the Scientific Medical Societies in Germany, AWMF; National Comprehensive Cancer Network, NCCN) were considered.

Results: Structured follow-up programs enable early detection of local recurrences and treatment-associated secondary neoplasms. Molecular approaches such as liquid biopsy offer promising perspectives for individualized, risk-adapted follow-up care but require further prospective validation. Lifestyle interventions, particularly smoking and alcohol cessation, are associated with a reduction in the risk of recurrence and second primary tumors. Human papillomavirus (HPV) vaccination exerts a preventive effect within the framework of primary prevention of HPV-associated tumors. Early functional rehabilitation in the domains of voice, swallowing, nutrition, and mobility substantially contributes to the prevention of persistent functional deficits.

Conclusion: Structured interdisciplinary follow-up care enables early detection of recurrence and improves functional outcomes as well as quality of life. However, innovative approaches require further clinical validation.