Endometrial cancer

The goal of monitoring is to detect recurrence as soon as it occurs; however, there is no evidence that this impacts on survival, and it may worsen anxiety and lead to expensive investigations and over-treatment.

Clinical follow-up should focus on signs and symptoms suggestive of recurrence, such as vaginal bleeding, abdominal or pelvic pain, persistent cough, unexplained weight loss, and new-onset neurologic symptoms.

The clinician can use the following schedule for follow-up:[76]National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: uterine neoplasms [internet publication]. https://www.nccn.org/guidelines/category_1

• Physical examination every 3 to 6 months for 2 to 3 years, then every 6 to 12 months until year 5, then annually.

• Imaging based on symptoms or exam findings that suggest recurrence.

Vaginal cytology, serum CA-125, and annual chest x-ray have no proven role in follow-up.[243]Cancer Care Ontario Program in Evidence-based Care Gynecology Cancer Disease Site Group. Follow-up after primary therapy for endometrial cancer: a systematic review. Jan 2006 (endorsed Jun 2017) [internet publication]. https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/616