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.
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.
Authors: E F Scanlon; M A Oviedo; M P Cunningham; J A Caprini; J D Khandekar; E Cohen; B Robinson; E Stein Journal: Cancer Date: 1980-08-15 Impact factor: 6.860
Authors: E Podczaski; P Kaminski; K Gurski; C MacNeill; J A Stryker; K Singapuri; T E Hackett; J Sorosky; R Zaino Journal: Gynecol Oncol Date: 1992-12 Impact factor: 5.482
Authors: D P Winchester; S F Sener; J D Khandekar; M A Oviedo; M P Cunningham; J A Caprini; F E Burkett; E F Scanlon Journal: Cancer Date: 1979-03 Impact factor: 6.860
Authors: Jessica Hunn; Meaghan E Tenney; Ana I Tergas; Erin A Bishop; Kathleen Moore; William Watkin; Carolyn Kirschner; Jean Hurteau; Gustavo C Rodriguez; Ernst Lengyel; Nita K Lee; S Diane Yamada Journal: Gynecol Oncol Date: 2015-03-30 Impact factor: 5.482
Authors: Christine Eiser; Kate Absolom; Diana Greenfield; John Snowden; Robert Coleman; Barry Hancock; Helena Davies Journal: J Cancer Surviv Date: 2007-03 Impact factor: 4.442