Endometrial Cancer Follow-up Research Articles

Clinical Impact of 18FDG-PET/CT in the Follow-up of Endometrial Cancer

In Brief Purpose: Endometrial cancer is the most frequent of gynecologic cancers in developed countries. Recurrence occurred mostly within the 2 years following initial therapy. Distant metastases are rare. This case report shows the clinical interest of 18F fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in long-term staging of endometrial cancer. Materials and Methods: A 74-year-old woman had undergone surgery and postoperative adjuvant radiotherapy and brachytherapy for an endometrial cancer. After a 12-year complete remission, an increase in tumor marker levels led to further investigations. Results: CT scan discovered a tumor, located under the liver, but with no hepatic lesion. FDG-PET/CT confirmed peritoneal carcinosis and discovered 3 hepatic metastases. Ultrasonography confirmed these findings. Patient underwent surgery for peritoneal carcinosis and one hepatic lesion and radiofrequency ablation for the 2 other hepatic tumors. Tumor marker levels normalized after therapy. CT scan and ultrasonography performed 1 and 3 months after treatment, respectively, led to false-positive results, as confirmed by a negative FDG-PET/CT performed 6 months after treatment. Conclusions: Whole-body FDG-PET contributes to the diagnosis of recurrence from endometrial cancer. It could be an accurate tool to check on early therapeutic success after radiofrequency ablation. Endometrial cancer is the most frequent of gynecologic cancers in developed countries. Whole-body FDG-PET contributes to the diagnosis of recurrence from endometrial cancer. It could be an accurate tool to check on early therapeutic success after radiofrequency ablation.

Secondary Cancer Prevention During Follow-up for Endometrial Cancer

To conduct a population-based study of incidence and screening rates for secondary breast and colorectal cancers after endometrial cancer and to assess implications for follow-up. This was a retrospective population-based study from administrative databases. The inception cohort included all women diagnosed with endometrial cancer in Ontario, Canada from 1996 to 2000, without a previous history of breast or colorectal cancer. We ascertained 5-year recurrence and overall survival rates and practitioner type during follow-up. Primary outcomes were age-standardized incidence and screening rates of breast and colorectal cancer during follow-up compared with the general female population. There were 3,473 women in the cohort. The 5-year recurrence rate was 15.0% and overall survival was 79.3%. Family physicians were most often involved in follow-up care. Age-standardized incidence rates of breast and colorectal cancer were 0.5% and 0.7%, respectively, compared with 0.5% (P=.76) and 0.2% (P<.001) in the general population. Age-standardized screening rates for these cancers were 64.0% and 30.0%, respectively, compared with 31.0% (P<.008) and 15.0% (P<.001) in the general population. Women aged older than 70 years and those with the lowest income were least likely to have secondary cancer screening. Women with endometrial cancer have a comparable risk of breast cancer but higher risk of colorectal cancer compared with the general population. Follow-up after endometrial cancer should include counseling and uptake of secondary cancer prevention strategies, which will contribute to maximizing long-term survivorship for these women. II.

The clinical value and the cost-effectiveness of follow-up in endometrial cancer patients.

The aim of the present article was to evaluate the cost-effectiveness of follow-up in endometrial cancer patients. A literature review was performed regarding the studies that addressed routine follow-up of endometrial cancer. For each published study, the costs of the follow-up program were calculated according to Belgium standards. A mean total of 13% relapsed. Symptomatology and clinical examination detected over 83% of the recurrences. The follow-up cost in euro after 5 and 10 years ranged between 127.68 and 2,028.78 and between 207.48 and 2,353.48, respectively. Based on the available data, there is little evidence of routine follow-up improving survival rates. Multiple protocols are used in practice without an evidence base. There is an urgent need for prospective randomized studies to evaluate the value of the current so-called 'standard medical practice of follow-up.' It is to be expected that the cost of follow-up could be reduced considerably, for instance, by tailoring to low- and high-risk groups, or by abandoning routine follow-up. Symptomatic patients, however, should be evaluated immediately. A reduction in the number of visits and examinations would mean an enormous reduction in costs. This economic benefit would be warmly welcomed in the times of increased health costs and decreased budgets.

Long-term follow-up of endometrial cancer managed by laparoscopy: Study of 161 women

Long-term follow-up of endometrial cancer managed by laparoscopy: Study of 161 women

The clinical value and the cost-effectiveness of follow-up in endometrial cancer patients

The aim of the present article was to evaluate the cost-effectiveness of follow-up in endometrial cancer patients. A literature review was performed regarding the studies that addressed routine follow-up of endometrial cancer. For each published study, the costs of the follow-up program were calculated according to Belgium standards. A mean total of 13% relapsed. Symptomatology and clinical examination detected over 83% of the recurrences. The follow-up cost in euro after 5 and 10 years ranged between 127.68 and 2028.78 and between 207.48 and 2353.48, respectively. Based on the available data, there is little evidence of routine follow-up improving survival rates. Multiple protocols are used in practice without an evidence base. There is an urgent need for prospective randomized studies to evaluate the value of the current so-called ‘standard medical practice of follow-up.’ It is to be expected that the cost of follow-up could be reduced considerably, for instance, by tailoring to low- and high-risk groups, or by abandoning routine follow-up. Symptomatic patients, however, should be evaluated immediately. A reduction in the number of visits and examinations would mean an enormous reduction in costs. This economic benefit would be warmly welcomed in the times of increased health costs and decreased budgets.