Efficacy of endometrial cancer follow-up protocols: time to change?
Rev. bras. ginecol. obstet; 43 (1), 2021
Publication year: 2021
Abstract Objective The aim of the present study was to analyze relapse rates and patterns in patients with endometrial cancer with the aim of evaluating the effectiveness of current follow-up procedures in terms of patient survival, as well as the convenience of modifying the surveillance strategy. Methods Retrospective descriptive study including all patients diagnosed with endometrial cancer relapse at the Department of Gynecology and Obstetrics of the Complejo Hospitalario Insular-Materno Infantil de Canarias, between 2005 and 2014. Results Recurrence was observed in 81 patients (10.04% of the sample); 66.7% of them suffered relapse within 2 years and 80.2% within 3 years after the termination of the primary treatment; 41.9% showed distant metastases while the rest corresponded to local-regional (40.7%) or ganglionar (17.4%) relapse; 42% of these were symptomatic; 14 patients showed more than 1 site of relapse. Relapse was detected mainly through symptoms and physical examination findings (54.3%), followed by elevated serummarker levels (29.6%), computed tomography (CT) images (9.9%) and abnormal vaginal cytology findings (6.2%). No differences in global survival were found between patients with symptomatic or asymptomatic relapse. Conclusion Taking into account that the recurrence rate of endometrial cancer is low, that relapse occurs mainly within the first 3 years post-treatment and that symptom evaluation and physical examination are the most effective follow-up methods, we postulate that a modification of the current model of hospital follow-up should be considered.
Carcinoma Endometrioide/diagnóstico por imagen, Carcinoma Endometrioide/mortalidad, Carcinoma Endometrioide/patología, Carcinoma Endometrioide/cirugía, Protocolos Clínicos/normas, Supervivencia sin Enfermedad, Neoplasias Endometriales/diagnóstico por imagen, Neoplasias Endometriales/mortalidad, Neoplasias Endometriales/patología, Neoplasias Endometriales/cirugía, Persona de Mediana Edad, Recurrencia Local de Neoplasia/diagnóstico por imagen, Recurrencia Local de Neoplasia/mortalidad, Recurrencia Local de Neoplasia/patología, Recurrencia Local de Neoplasia/cirugía, Estadificación de Neoplasias, Evaluación de Resultado en la Atención de Salud, Estudios Retrospectivos, España, Tomografía Computarizada por Rayos X, Servicios de Salud para Mujeres