OBJECTIVE: To determine current practice of follow-up of Norwegian gynecological cancer patients, and to review available randomized controlled trials (RCTs) in gynecologic, breast and colorectal cancer patients in order to discuss whether such studies are feasible in gynecological cancer patients. DESIGN: A combined questionnaire study and a systematic review of RCTs in follow-up of gynecological, breast, and colorectal cancers. POPULATION: Gynecological, breast, and colorectal cancer patients. METHODS: A questionnaire regarding follow-up routines was mailed to 31 gynecological departments in Norway. A systematic search on MEDLINE, EMBASE, and the Cochrane Library databases was conducted to identify RCTs in follow-up of breast, colorectal, and gynecological cancers. RESULTS: The questionnaire study showed that the number of controls varied from eight to 16 during the first five years' post-treatment. Routine investigations such as chest X-ray and cytology were frequently used in endometrial and cervical cancer. All departments used CA-125 in follow-up of ovarian cancer patients. Reviewing the literature, 19 RCTs of varying methodological quality were identified for colorectal and breast cancers, and none for gynecologic cancer. Different follow-up models were compared, and most studies concluded that there were no significant differences in the detection of recurrence, overall survival, and quality of life between the studied groups. CONCLUSIONS: Follow-up routines after gynecological cancer vary in Norway. The optimal approach is unknown and RCTs comparing follow-up protocols are missing. Studies of breast and colorectal cancer patients show that studies on follow-up strategies are feasible but sufficient sample size and observation time are important.
OBJECTIVE: To determine current practice of follow-up of Norwegian gynecological cancerpatients, and to review available randomized controlled trials (RCTs) in gynecologic, breast and colorectal cancerpatients in order to discuss whether such studies are feasible in gynecological cancerpatients. DESIGN: A combined questionnaire study and a systematic review of RCTs in follow-up of gynecological, breast, and colorectal cancers. POPULATION: Gynecological, breast, and colorectal cancerpatients. METHODS: A questionnaire regarding follow-up routines was mailed to 31 gynecological departments in Norway. A systematic search on MEDLINE, EMBASE, and the Cochrane Library databases was conducted to identify RCTs in follow-up of breast, colorectal, and gynecological cancers. RESULTS: The questionnaire study showed that the number of controls varied from eight to 16 during the first five years' post-treatment. Routine investigations such as chest X-ray and cytology were frequently used in endometrial and cervical cancer. All departments used CA-125 in follow-up of ovarian cancerpatients. Reviewing the literature, 19 RCTs of varying methodological quality were identified for colorectal and breast cancers, and none for gynecologic cancer. Different follow-up models were compared, and most studies concluded that there were no significant differences in the detection of recurrence, overall survival, and quality of life between the studied groups. CONCLUSIONS: Follow-up routines after gynecological cancer vary in Norway. The optimal approach is unknown and RCTs comparing follow-up protocols are missing. Studies of breast and colorectal cancerpatients show that studies on follow-up strategies are feasible but sufficient sample size and observation time are important.
Authors: Padraig Dixon; Kinta Beaver; Susan Williamson; Chris Sutton; Pierre Martin-Hirsch; William Hollingworth Journal: Appl Health Econ Health Policy Date: 2018-06 Impact factor: 2.561
Authors: Nicole P M Ezendam; Belle H de Rooij; Roy F P M Kruitwagen; Carien L Creutzberg; Ingrid van Loon; Dorry Boll; M Caroline Vos; Lonneke V van de Poll-Franse Journal: Trials Date: 2018-04-16 Impact factor: 2.279