Abstract

Objective:

The value of follow-up after treatment for endometrial cancer will be discussed.

Study Design:

We evaluated our clinical experience, including mode of detection, of patients with recurrent endometrial cancer treated in the Erasmus Medical Centre in Rotterdam over a 20-year period. Clinical data and histopathological features from 64 patients were analyzed. Survival was analyzed with a Kaplan–Meier curve.

Results:

Twenty-two patients had a local recurrence, 30 had a distant recurrence and 12 had simultaneous local and distant recurrent disease. Ninety-five percent of the local recurrences and 67% of the distant recurrences were detected within three years. Twenty-seven patients had a screen-detected recurrence, 34 had an interval screening recurrence and two had a chance finding recurrence. The overall survival rate at two years was 70% and at five years 53%. Patients with a screen-detected recurrence had a 5-year survival rate of 62%, while patients with interval screening and chance finding recurrences had a 5-year survival rate of 47%.

Conclusion:

A follow-up program in the first three years after primary treatment of endometrial cancer is useful in detecting recurrent disease. We have no reason to use a different program of follow-up in patients with low risk primary disease (Fig 1).

Figure 1: Kaplan–Meier survival curve for patients with recurrent endometrial cancer according to mode of detection. (Reprinted from van Wijk FH, Huikeshoven FJ, Abdulkadir L, et al. Recurrent endometrial cancer: a retrospective study. Eur J Obstet Gynecol Reprod Biol. 2007;130:114-120, with permission from the Elsevier.)