Costs and Benefits of Routine Follow-up After Curative Treatment for Endometrial Cancer

Overview

Journal CMAJ

Date 1997 Nov 5

PMID 9327795

Citations 15

Authors

O O Agboola

E Grunfeld

D Coyle

G A Perry

Affiliations

Soon will be listed here.

Abstract

Objective: To examine the costs of routine outpatient follow-up after curative treatment of endometrial cancer, and to determine whether this leads to early detection of recurrence or survival. The impact of specific disease characteristics on survival is examined.

Design: Retrospective chart review, and calculation of costs.

Setting: Ottawa Regional Cancer Centre-Civic Division (ORCC-C).

Patients: All 432 patients referred to the ORCC-C with endometrial cancer between 1982 and 1991 who received treatment with curative intent and who continued with routine follow-up.

Results: Cancer recurred in 50 patients (11.57%). There was no statistically significant difference in overall survival between patients with symptomatic and asymptomatic recurrences, or between those with recurrences detected during routine follow-up visits or in the interval between routine visits. Of 4830 Papanicolaou (Pap) smears performed routinely, cancer was detected in 6 cases. The mean cost of the routine follow-up procedures for each patient with a recurrence was $19,200.

Conclusion: Intensive follow-up of women with endometrial cancer does not result in improved survival. A prospective randomized study is warranted to evaluate other potential benefits of follow-up, such as improved quality of life or decreased morbidity. There is no economic or clinical justification for the routine use of the Pap smear in the follow-up of patients with endometrial cancer. The potential benefits of routine follow-up in endometrial cancer and other types of cancer with favourable prognoses warrant critical evaluation.

Citing Articles

Reassessment of intensive surveillance practices adopted for endometrial cancer survivors.

Nakamura K, Kitahara Y, Yamashita S, Kigure K, Ito I, Nishimura T BMC Womens Health. 2022; 22(1):355.

PMID: 35999573 PMC: 9396785. DOI: 10.1186/s12905-022-01937-1.

Cancer of the corpus uteri: 2021 update.

Koskas M, Amant F, Mirza M, Creutzberg C Int J Gynaecol Obstet. 2021; 155 Suppl 1:45-60.

PMID: 34669196 PMC: 9297903. DOI: 10.1002/ijgo.13866.

Stage one endometrioid endometrial adenocarcinoma: is there a role of traditional hospital follow-up in the detection of cancer recurrence in women after treatment?.

Nikolopoulos M, Godfrey M, Sohrabi F, Wong M, Bhatte D, Wuntakal R Obstet Gynecol Sci. 2021; 64(6):506-516.

PMID: 34517692 PMC: 8595042. DOI: 10.5468/ogs.21137.

How Do We Follow Up Patients With Endometrial Cancer?.

Jeppesen M, Mogensen O, Hansen D, Bergholdt S, Jensen P Curr Oncol Rep. 2019; 21(7):57.

PMID: 31093835 DOI: 10.1007/s11912-019-0805-3.

Stratification of risk groups according to survival after recurrence in endometrial cancer patients.

Shim S, Kim D, Kim H, Lee S, Park J, Suh D Medicine (Baltimore). 2017; 96(21):e6920.

PMID: 28538383 PMC: 5457863. DOI: 10.1097/MD.0000000000006920.

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