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Recurrent stage IB cervical carcinoma: evaluation of the effectiveness of routine follow up surveillance
A Ansink1, A de Barros Lopes, R Naik
1Regional Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, UK.
Objective:
To study the effectiveness of follow up surveillance in detecting recurrent disease following radical hysterectomy for Stage IB cervical carcinoma.
Design:
Retrospective analysis of clinical records using a computerised database.
Participants:
Six hundred and seventy-four patients with Stage IB carcinoma of the cervix underwent radical hysterectomy and lymph node dissection.
Interventions:
Standard follow up surveillance consisted of clinical history and physical examination six weeks post surgery, and subsequently three monthly for the first year, six monthly for the second year, and yearly thereafter until 10 years post-treatment.
Results:
Of the 674 patients, 112 (17%) developed recurrent disease. In only 29/112 (26%) was recurrent disease detected at the time of routine follow up visits. Nearly half of the patients (44%) were referred by their general practitioner between visits to the clinic because of suspicion of recurrent disease.
Conclusion:
Routine follow up surveillance is ineffective in detecting recurrent cervical carcinoma. Only one in four recurrences were detected at the time of a clinical visit.
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