RISK-SPECIFIC FOLLOW-UP FOR ENDOMETRIAL CARCINOMA PATIENTS

Objective: To propose a risk-specific follow-up protocol for endometri al carcinoma patients. Methods: A retrospective cohort of endometrial carcinoma patients was used to identify risk factors for recurrence. B ased on a profile of risk factors, women were classified at either low or high risk for recurrence (median follow-up 70 months). The classif ication system was validated on a subsequent cohort. Results: Surgical stage, grade, and histology were found to be significant predictors ( P < 0.001) of recurrence. In the original cohort, patients with stage Ia, grade 1 or 2, or stage Ib, grade 1 adenocarcinoma, had a recurrenc e rate of 4/98 (4.1%). The remaining high-risk patients had a recurren ce rate of 37/158 (23.4%), When applied to the subsequent cohort, the rates were similar: low risk 3/113 (2.7%) and high risk 30/140 (21.4%) . Seventy-five percent of recurrences occurred within 3 years of diagn osis and the majority were heralded by site-specific symptoms. Conclus ions: Women with endometrial carcinoma can be successfully classified for low or high risk of recurrence. It is proposed that low-risk patie nts not be maintained on routine follow-up and that a tailored schedul e of follow-up be used for high-risk patients. These changes would ser ve patients more appropriately and use health care resources more effi ciently. (C) 1997 Academic Press.