Surveillance Procedures for Patients Treated for Endometrial Cancer: A Review of the Literature

Sartori, Enrico; Pasinetti, Brunella; Chiudinelli, Francesca; Gadducci, Angiolo; Landoni, Fabio; Maggino, T; Piovano, Elisa; Zola, Paolo

doi:10.1111/igc.0b013e3181e2abcc

Cited by 56 publications

(42 citation statements)

References 30 publications

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Section: Follow-up In Gynaecological Oncologymentioning

confidence: 99%

“…Recurrence of endometrial cancer is often symptomatic although reported to vary from 40-91% (23)(24)(25)27,28,(30)(31)(32). Most recurrences (70-95 %) occur within three years of initial treatment [31,33]. Symptomatic recurrences of endometrial cancer may have a worse prognosis than asymptomatic recurrences, as reported from recent studies carried out in Italy and Japan [34,35], although evidence is conflicting as other studies showed no such differences [23,36,37].…”

Section: Follow-up In Gynaecological Oncologymentioning

confidence: 99%

“…Symptomatic recurrences of endometrial cancer may have a worse prognosis than asymptomatic recurrences, as reported from recent studies carried out in Italy and Japan [34,35], although evidence is conflicting as other studies showed no such differences [23,36,37]. There is no consensus on what tests should be offered for endometrial cancer follow-up [31]. The Society for Gynecologic Oncology recommends a pelvic examination at each visit but suggests that routine CA125 testing, chest radiography and vaginal cytology is controversial and that there is no randomised data to guide practice [38].…”

Section: Follow-up In Gynaecological Oncologymentioning

confidence: 99%

“…Seventy per cent of all tumour related expenditure is spent on follow-up [31]. This means that a large amount of clinical time and costs are targeted to care after treatment rather than treatment itself.…”

Section: Economic Evaluation Of Oncology Follow-upmentioning

confidence: 99%

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The future for follow-up of gynaecological cancer in Europe. Summary of available data and overview of ongoing trials

Leeson

Beaver

Ezendam

et al. 2017

European Journal of Obstetrics & Gynecology and Reproductiv

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After completing treatment, most patients follow a pre-determined schedule of regular hospital outpatient appointments, which includes clinical examinations, consultations and routine tests. More work is needed on alternative strategies for all gynaecological cancer types. New models will likely include risk stratification with early discharge from secondary care for early stage disease with fast track access to specialist services for suspected cancer recurrence or other problems.

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Section: Follow-up In Gynaecological Oncologymentioning

confidence: 99%

Section: Follow-up In Gynaecological Oncologymentioning

confidence: 99%

Section: Follow-up In Gynaecological Oncologymentioning

confidence: 99%

Section: Economic Evaluation Of Oncology Follow-upmentioning

confidence: 99%

See 2 more Smart Citations

The future for follow-up of gynaecological cancer in Europe. Summary of available data and overview of ongoing trials

Leeson

Beaver

Ezendam

et al. 2017

European Journal of Obstetrics & Gynecology and Reproductiv

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“…In clinical practice, there appears to be no rationale available for any particular follow-up protocol 26. As there is a lack of any demonstrable survival benefit for the follow-up of gynaecological cancer patients, other schedules of care could be considered.…”

Section: Introductionmentioning

confidence: 99%

Gynaecological cancer follow-up: national survey of current practice in the UK

et al. 2013

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ObjectiveTo establish a baseline of national practice for follow-up after treatment for gynaecological cancer.DesignQuestionnaire survey.SettingGynaecological cancer centres and units.Geographical locationUK.ParticipantsMembers of the British Gynaecological Cancer Society and the National Forum of Gynaecological Oncology Nurses.InterventionsA questionnaire survey.Outcome measuresTo determine schedules of follow-up, who provides it and what routine testing is used for patients who have had previous gynaecological cancer.ResultsA total of 117 responses were obtained; 115 (98%) reported hospital scheduled regular follow-up appointments. Two involved general practitioners. Follow-up was augmented or replaced by telephone follow-up in 29 responses (25%) and patient-initiated appointments in 38 responses (32%). A total of 80 (68%) cancer specialists also offered combined follow-up clinics with other specialties. Clinical examinations for hospital-based follow-up were mainly performed by doctors (67% for scheduled regular appointments and 63% for patient-initiated appointments) while telephone follow-up was provided in the majority by nurses (76%). Most respondents (76/117 (65%)) provided routine tests, of which 66/76 (87%) reported carrying out surveillance tests for ovarian cancer, 35/76 (46%) for cervical cancer, 8/76 (11%) for vulval cancer and 7/76 (9%) for endometrial cancer. Patients were usually discharged after 5 years (82/117 (70%)), whereas three (3%) were discharged after 4 years, nine (8%) after three years and one (1%) after 2 years.ConclusionsPractice varied but most used a standard hospital-based protocol of appointments for 5 years and routine tests were performed usually for women with ovarian cancer. A minority utilised nurse-led or telephone follow-up. General practitioners were rarely involved in routine care. A randomised study comparing various models of follow-up could be considered.

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