Postsurgical Surveillance of Patients with FIGO Stage I/II Endometrial Adenocarcinoma

doi:10.1006/gyno.1995.1262

Gynecologic Oncology

Volume 59, Issue 1, October 1995, Pages 20-24

https://doi.org/10.1006/gyno.1995.1262 Get rights and content

Abstract

Objective: To examine the effect of postsurgical surveillance on survival of patients with FIGO stage I/II endometrial adenocarcinoma. Methods: We examined the records of 354 patients who underwent primary surgical therapy for FIGO stage I/II endometrial adenocarcinoma. In patients who developed recurrent disease, we determined whether symptoms or signs of disease were present at recurrence and whether there was evidence of disease on Pap smear or chest radiograph. Results: Among the 354 patients in this study, 44 (12%) developed recurrent disease. Sites of recurrence included 12 (27%) isolated vaginal, 12 (27%) pelvis with vagina or abdomen, 4 (10%) isolated lung, 13 (29%) pelvic/abdominal with other distant sites, and 3 (7%) other distant sites. At diagnosis of recurrence 61% of patients had symptoms related to their cancer, 68% had physical exam findings suggestive of recurrence, and 84% had symptoms and/or signs. Findings consistent with recurrent cancer were detected by Pap smear in 25% and on chest radiograph in 20%. Among the 44 patients who developed recurrent disease, 8 (18%) remain alive without evidence of disease, including 6/12 (50%) with isolated vaginal disease and 2/34 (6%) with other patterns of recurrent disease (P = 0.01). Among the 12 patients with isolated vaginal recurrence, 1/3 (33%) in whom recurrent disease was diagnosed by Pap smear alone was salvaged compared to 5/9 (56%) who had symptoms or signs of vaginal recurrence. None of the three patients in whom an abnormal chest radiograph was the only evidence of recurrence survived. Conclusions: Because of the low recurrence rate of FIGO stage I/II endometrial cancer and the paucity of effective second-line treatment, surveillance Pap smears and chest radiographs appear to have little impact on survival. Although few asymptomatic potentially curable recurrences were detected due to surveillance examinations, the value of psychological reassurance associated with a normal examination is difficult to quantitate.

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Citation Excerpt :
Chest radiographs have been advocated for the detection of asymptomatic chest recurrences, often on a semi-annual or annual basis. However, the rate of detection for asymptomatic chest recurrences found on chest radiographs ranges only from 0% to 20% [87,90]. Thus, this procedure may not be appropriate for this group.
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Regular ArticlePostsurgical Surveillance of Patients with FIGO Stage I/II Endometrial Adenocarcinoma

Abstract

Regular Article
Postsurgical Surveillance of Patients with FIGO Stage I/II Endometrial Adenocarcinoma