Value and cost evaluation of routine follow-up for patients with clinical stage I/II endometrial cancer.
The aim of the study was to determine the value and the costs of routine follow-up for the detection of recurrences in patients treated for endometrial cancer. Between 1986 and 1995, 390 women with clinical stage I/II endometrial carcinoma were treated with combined surgery-radiation therapy. After treatment, follow-up was based on the clinical examination, a systematic Papanicolaou (Pap) smear and radiography (chest X-ray and abdomino-pelvic ultrasonography). 27 patients relapsed: 22 patients had symptoms and 5 were asymptomatic. None of the patients had recurrence detected on the routine Pap smear nor on the systematic chest X-ray. In conclusion, the follow-up of patients treated for endometrial cancer based on routine Pap smears and systematic radiography does not permit earlier detection of recurrences. Follow-up should simply include a clinical examination whose frequency should be based on prognostic factors. Approximately two-thirds of this cost was due to systematic examinations (Pap smears and radiography). Our results indicate that such expenditure could be avoided.
Morice
P
P
Department of Gynecologic Surgery, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805, Villejuif, France. morice@igr.fr
Levy-Piedbois
C
C
Ajaj
S
S
Pautier
P
P
Haie-Meder
C
C
Lhomme
C
C
Duvillard
P
P
Castaigne
D
D
D000368:Aged; D003131:Combined Modality Therapy / Q000191:economics / Q000379:methods; D003362:Cost-Benefit Analysis; D016889:Endometrial Neoplasms / Q000191:economics* / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies