Efficacy of routine follow-up in patients with recurrent uterine cancer

Smith, Christopher J., Heeren, Monique, Nicklin, James L., Perrin, Lewis C., Land, Russell, Crandon, Alex J. and Obermair, Andreas (2007) Efficacy of routine follow-up in patients with recurrent uterine cancer. Gynecologic Oncology, 107 1: 124-129. doi:10.1016/j.ygyno.2007.06.002


Author Smith, Christopher J.
Heeren, Monique
Nicklin, James L.
Perrin, Lewis C.
Land, Russell
Crandon, Alex J.
Obermair, Andreas
Title Efficacy of routine follow-up in patients with recurrent uterine cancer
Journal name Gynecologic Oncology   Check publisher's open access policy
ISSN 0090-8258
1095-6859
Publication date 2007-10
Sub-type Article (original research)
DOI 10.1016/j.ygyno.2007.06.002
Volume 107
Issue 1
Start page 124
End page 129
Total pages 6
Place of publication New York, U.S.A.
Publisher Academic Press
Language eng
Subject 1112 Oncology and Carcinogenesis
Formatted abstract
Objective:
To evaluate the efficacy of routine follow-up in patients with recurrent uterine cancer.

Methods:
In a single institution study, a total of 2637 patients were treated curatively for uterine cancer from 1990 to 2006. A total of 438 patients experienced disease recurrence. Data for detailed analysis were available from 280 of the 438 patients. Prior to the diagnosis of recurrence, all patients had regular follow-up and were investigated through internal examination, vaginal vault cytology and imaging. Overall survival (OS) was the main study endpoint and was calculated from recurrence diagnosis to death or date censored.

Results:

Clinical and histopathological features as well as patterns of recurrence were similar in symptomatic and asymptomatic patients. Eighty-one patients (28.9%) were diagnosed with asymptomatic recurrence while 199 patients (71.1%) presented with symptomatic recurrence. The overall survival probability at 5 years was 41.0% and 28.9% respectively for asymptomatic and symptomatic patients (log-rank p = 0.013). Those patients with stage 1 or 2 tumors of endometrioid type were found to have an overall survival probability at 5 years of 38.0% and 25.7% respectively for asymptomatic and symptomatic recurrence (log-rank p = 0.05). The absence of symptoms did not impact on the outcome of patients with stage 3 tumors or tumors of non-endometrioid type.

Conclusions:
While patients at low/intermediate risk of recurrence may benefit from intensive follow-up including internal examinations, routine vaginal vault cytology and imaging, high-risk patients might gain more from an alternate follow-up strategy with emphasis on imaging in conjunction with symptom education.

Crown copyright © 2007 Published by Elsevier Inc.

Keyword Uterine cancer
Recurrence
Vaginal vault cytology
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Thu, 14 Jan 2010, 14:52:50 EST by Gerald Martin on behalf of Faculty Of Health Sciences