Routine follow-up after treatment of endometrial carcinomas

Objective: Intensive follow-up protocols for patients treated for breast cancer have not improved survival rates. We evaluated the efficacy of routine measures in the follow-up of patients treated for endometrial cancer. Methods: We reviewed records of 854 patients treated for endometrial cancer between 1986 and 1996 at the Department of Gynaecological Oncology and Radiotherapy of the University of Giessen no evidence of disease after primary treatment (at least for 3 months). We analyzed the number of follow-up visits, site of follow-up (university center vs. practicing physician), and sites of recurrence with respect to patients' prognosis and survival. Results: During the first year after diagnosis most patients were seen at the university center. Thereafter 60% of patients (mostly younger patients and those with earlier stage disease) were followed by physicians in practice, without any discernible disadvantage. 93 patients (11%), usually older ones, did not attend follow-up visits and had a significantly worse prognosis (logrank 88.3, df = 3, p < 0.001). About half of the primary recurrences (n = 148) were detected on the basis of clinical symptoms. The prognosis was influenced by the site of recurrence but not by whether or not the patients had symptoms (log rank = 14.3, df = 5, p = 0.014). Conclusion: These data suggest that intensive diagnostic follow-up of patients treated for endometrial cancer does not improve survival but also that follow-up is beneficial compared with no follow-up.