OVARIAN CANCER and US: followup; Surveillance

Review

Posttreatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncologists recommendations

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Ritu Salani MD, MBA^a^,^,, Floor J. Backes MD^a, Michael Fung Kee Fung MB, BS^b, Christine H. Holschneider MD^c, Lynn P. Parker MD^d, Robert E. Bristow MD, MBA^e and Barbara A. Goff MD^f

^a The Ohio State University, Columbus, OH
^b University of Ottawa, Ontario, Canada
^c David Geffen School of Medicine at UCLA, Los Angeles, CA
^d University of Louisville Louisville, KY
^e University of California Irvine Medical Center Orange, CA
^f University of Washington School of Medicine Seattle, WA

Received 19 February 2011;

accepted 8 March 2011.

Available online 11 June 2011.

Although gynecologic cancers account for only 10% of all new cancer cases in women, these cancers account for 20% of all female cancer survivors. Improvements in cancer care have resulted in almost 10 million cancer survivors, and this number is expected to grow. Therefore, determining the most cost-effective clinical surveillance for detection of recurrence is critical. Unfortunately, there has been a paucity of research in what are the most cost-effective strategies for surveillance once patients have achieved a complete response. Currently, most recommendations are based on retrospective studies and expert opinion. Taking a thorough history, performing a thorough examination, and educating cancer survivors about concerning symptoms is the most effective method for the detection of most gynecologic cancer recurrences. 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. This article will review the most recent data on surveillance for gynecologic cancer recurrence in women who have had a complete response to primary cancer therapy.

Key words: cervical cancer; cytology; endometrial cancer; gynecologic cancer; imaging; ovarian cancer; surveillance