Value and cost evaluation of routine follow-up for patients with clinical stage I/II endometrial cancer

The aim of the study was to determine the value and the costs of routine fo llow-up for the detection of recurrences in patients treated for endometria l cancer. Between 1986 and 1995. 390 women with clinical stage I/II endomet rial carcinoma were treated with combined surgery-radiation therapy. After treatment, follow-up was based on the clinical examination. a systematic Pa panicolaou (Pap) smear and radiography (chest X-ray and abdomino-pelvic ult rasonography). 27 patients relapsed: 22 patients had symptoms and 5 were as ymptomatic. None of the patients had recurrence detected on the routine Pap smear nor on the systematic chest Xray. In conclusion, the follow-up of pa tients treated for endometrial cancer based on routine Pap smears and syste matic radiography does not permit earlier detection of recurrences. Follow- up should simply include a clinical examination whose frequency should be b ased on prognostic factors. Approximately two-thirds of this cost was due t o systematic examinations (Pap smears and radiography). Our results indicat e that such expenditure could be avoided. (C) 2001 Elsevier Science Ltd. Al l rights reserved.