Intensive surveillance failed to improve outcome after treatment for endometrial cancer

42nd Annual Meeting of the Society for Gynecologic Oncologists

ORLANDO — Women who underwent intensive surveillance after being treated for endometrial cancer did not have a better outcome than those who presented only when symptomatic, according to researchers.

“Screening for recurrent endometrial cancer in women with early-stage disease using physical exams, pap smears and chest X-rays is of limited utility, as our study has shown that women diagnosed through the result of intensive surveillance did not have a better outcome than women who presented with symptomatic disease,” said presenter Joshua P. Kesterson, MD, a fellow at Roswell Park Cancer Institute in Buffalo, N.Y.

After treatment for early-stage endometrial cancer, the National Comprehensive Cancer Network recommends a physical and vaginal cytology every 3 to 6 months for 2 years, and then every 6 to 12 months with annual chest X-rays. The researchers evaluated whether this intensive strategy improved the survival in women diagnosed with recurrent early-stage endometrial cancer.

The Roswell Park Cancer Institute Cancer Registry was used to identify patients who had stage I or stage II endometrial cancer treated from 1990 to 2007. Patients were divided into two groups: asymptomatic women who were diagnosed with recurrence as a result of routine screening, and women who were diagnosed with recurrence after presenting with symptoms. After controlling for variables that included age, adjuvant treatment, grade, recurrence site and stage, the researchers compared OS between the groups.

There were 850 patients with stage I or stage II endometrial cancer, of which there were 52 patients with recurrent disease identified. Among those with recurrent disease, 23 were diagnosed via routine screening methods and 29 were symptomatic at presentation.

The median survival was 79 months for those diagnosed during routine screening and 80 months for symptomatic patients. After 5 years, 55% of the patients diagnosed during routine screening were still alive vs. 59% of symptomatic patients.

For more information:

Kesterson J. #25. Presented at: 42nd Annual Meeting of the Society of Gynecologic Oncologists; March 6-9, 2011; Orlando, Fla.

Disclosure: The researchers report no relevant financial disclosures.

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