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

Max Rohde*, Tine Rosenberg, Manan Pareek, Paul Nankivell, Neil Sharma, Hisham Mehanna, Christian Godballe

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

2 Citations (Scopus)
145 Downloads (Pure)


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 HN:SCC?”. 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.

Original languageEnglish
Pages (from-to)1593-1599
Number of pages7
JournalEuropean Archives of Oto-Rhino-Laryngology
Issue number6
Early online date7 Apr 2020
Publication statusPublished - Jun 2020


  • Definition
  • Head and neck neoplasms
  • Recurrence
  • Relapse

ASJC Scopus subject areas

  • Otorhinolaryngology


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