Most gynecologic cancers recurrences occur within three years after primary treatment, but patients usually are transitioned back to their primary-care providers (PCPs) during the first two to three years.
PCPs should be aware that the most effective method for detecting most gynecologic-cancer recurrences is three-pronged, according to the expert recommendations recently released by the Society of Gynecologic Oncology: (1) take a thorough history, (2) perform a thorough examination, and (3) educate the patient about concerning symptoms.
“There is very little evidence that routine cytologic procedures or imaging improves the ability to detect gynecologic cancer recurrence at a stage that will impact cure or response rates to salvage therapy,” the guideline authors wrote (Am J Obstet Gynecol. 2011;204:466-478).
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The new clinical document reviews the most recent data on surveillance for gynecologic cancer recurrence in women who have had a complete response to primary cancer therapy, and offers recommendations for surveillance of endometrial, ovarian, cervical, vulvar and vaginal cancers — specifying when various examinations, tests and imaging should be ordered in the months and years following treatment. The document also includes a checklist for gynecologic malignancy surveillance.
“The goal of follow-up evaluation for the detection of recurrent disease requires both clinical and cost-effectiveness,” the researchers noted. “Failure to adhere to recommended guidelines results in unnecessary tests, and efforts should be made to provide effective surveillance, which will result in cost-savings.”
