AN EVALUATION OF ROUTINE FOLLOW-UP OF PATIENTS TREATED FOR ENDOMETRIAL CARCINOMA

This retrospective review evaluates the outcome benefit of a standard follow-up protocol for 435 patients treated for endometrial carcinoma between 1981 and 1986. Routine follow-ups consisting of physical exami nations and vaginal cytologies were done every 3 months for the first year, 4 months for the second year, and 6 months thereafter. Chest X r ays were done biannually. Demographic, histopathologic, therapeutic, a nd followup data were studied. Exclusions due to incomplete follow-up (70), persistent disease (40), or other primary malignancies (8) left 317 patients with a disease-free state assigned to follow-up. Recurren ces developed in 53 patients being followed, 40 (75%) of whom were sym ptomatic. Family physicians primarily diagnosed recurrences in 34 pati ents while recurrences in only 11 of the 53 patients (21%) were detect ed on routine follow-up at the cancer center (5 by examination and 6 b y chest X ray). Therefore, only one recurrence was detected for every 206 routine follow-up visits. Vaginal vault cytology was not diagnosti c in any patient. Seventy percent of recurrences occurred within 3 yea rs. There was no statistical difference in survival between the group detected on routine follow-up and those who were symptomatic (P = 0.55 ), Routine follow-up of patients treated for endometrial cancer did no t improve detection of recurrences or survival. (C) 1994 Academic Pres s, Inc.