M. C. Knox, A. Salkeld, A. Brand, U. Herbst, J. Chard, N. Thiruthaneeswaran
{"title":"常规盆腔检查在子宫内膜癌辅助放疗患者随访中的价值：澳大利亚三级中心经验。","authors":"M. C. Knox, A. Salkeld, A. Brand, U. Herbst, J. Chard, N. Thiruthaneeswaran","doi":"10.1111/1754-9485.13864","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Pelvic examination is a routine component of post-treatment surveillance for endometrial cancer, supported by global guidelines. However, there is no evidence of oncological or quality-of-life benefit, with data suggesting associated discomfort and potential psychological harm. We evaluate the value of routine pelvic examination in follow-up protocols after adjuvant radiation therapy.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We retrospectively reviewed all patients receiving adjuvant radiation therapy for endometrial carcinoma across two combined cancer services between January 2017 and December 2022. All stages and histological subtypes were eligible. At least 12 months of documented follow-up was required. Patients were stratified by FIGO stage (2009 and 2023) and ESGO/ESTRO risk group.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Two hundred and sixty-four of 395 patients met inclusion criteria, with a median follow-up of 34 months. Whilst demographics were widely distributed, the most common features included endometrioid histology (76.5%), FIGO 2023 stage II (48.5%) and ESGO/ESTRO high-risk (36.7%).</p>\n \n <p>Disease recurrence was identified in 41 patients (15.5%). Only four patients had isolated local recurrence, with most also having distant disease at detection. Only three patients had asymptomatic recurrence found on examination (1.1% of cohort), with only one proceeding to salvage therapy (0.4% of cohort). As expected, higher-risk groups were associated with worse overall survival (<i>p</i> < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>We found routine pelvic examination following adjuvant radiation therapy for endometrial cancer results in low recurrence detection rates, with salvageable local recurrences being rare. We advocate for the omission of routine pelvic examination from follow-up protocols for patients receiving adjuvant radiation therapy, with either clinic-based or telephone-based follow-up being offered on a risk-stratified basis.</p>\n </section>\n </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"69 4","pages":"531-539"},"PeriodicalIF":2.2000,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13864","citationCount":"0","resultStr":"{\"title\":\"Value of Routine Pelvic Examination in the Follow-Up of Patients Receiving Adjuvant Radiation Therapy for Endometrial Cancer: An Australian Tertiary-Centre Experience\",\"authors\":\"M. C. Knox, A. Salkeld, A. Brand, U. Herbst, J. Chard, N. Thiruthaneeswaran\",\"doi\":\"10.1111/1754-9485.13864\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Pelvic examination is a routine component of post-treatment surveillance for endometrial cancer, supported by global guidelines. However, there is no evidence of oncological or quality-of-life benefit, with data suggesting associated discomfort and potential psychological harm. We evaluate the value of routine pelvic examination in follow-up protocols after adjuvant radiation therapy.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We retrospectively reviewed all patients receiving adjuvant radiation therapy for endometrial carcinoma across two combined cancer services between January 2017 and December 2022. All stages and histological subtypes were eligible. At least 12 months of documented follow-up was required. Patients were stratified by FIGO stage (2009 and 2023) and ESGO/ESTRO risk group.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Two hundred and sixty-four of 395 patients met inclusion criteria, with a median follow-up of 34 months. Whilst demographics were widely distributed, the most common features included endometrioid histology (76.5%), FIGO 2023 stage II (48.5%) and ESGO/ESTRO high-risk (36.7%).</p>\\n \\n <p>Disease recurrence was identified in 41 patients (15.5%). Only four patients had isolated local recurrence, with most also having distant disease at detection. Only three patients had asymptomatic recurrence found on examination (1.1% of cohort), with only one proceeding to salvage therapy (0.4% of cohort). 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Value of Routine Pelvic Examination in the Follow-Up of Patients Receiving Adjuvant Radiation Therapy for Endometrial Cancer: An Australian Tertiary-Centre Experience
Introduction
Pelvic examination is a routine component of post-treatment surveillance for endometrial cancer, supported by global guidelines. However, there is no evidence of oncological or quality-of-life benefit, with data suggesting associated discomfort and potential psychological harm. We evaluate the value of routine pelvic examination in follow-up protocols after adjuvant radiation therapy.
Methods
We retrospectively reviewed all patients receiving adjuvant radiation therapy for endometrial carcinoma across two combined cancer services between January 2017 and December 2022. All stages and histological subtypes were eligible. At least 12 months of documented follow-up was required. Patients were stratified by FIGO stage (2009 and 2023) and ESGO/ESTRO risk group.
Results
Two hundred and sixty-four of 395 patients met inclusion criteria, with a median follow-up of 34 months. Whilst demographics were widely distributed, the most common features included endometrioid histology (76.5%), FIGO 2023 stage II (48.5%) and ESGO/ESTRO high-risk (36.7%).
Disease recurrence was identified in 41 patients (15.5%). Only four patients had isolated local recurrence, with most also having distant disease at detection. Only three patients had asymptomatic recurrence found on examination (1.1% of cohort), with only one proceeding to salvage therapy (0.4% of cohort). As expected, higher-risk groups were associated with worse overall survival (p < 0.001).
Conclusions
We found routine pelvic examination following adjuvant radiation therapy for endometrial cancer results in low recurrence detection rates, with salvageable local recurrences being rare. We advocate for the omission of routine pelvic examination from follow-up protocols for patients receiving adjuvant radiation therapy, with either clinic-based or telephone-based follow-up being offered on a risk-stratified basis.
期刊介绍：
Journal of Medical Imaging and Radiation Oncology (formerly Australasian Radiology) is the official journal of The Royal Australian and New Zealand College of Radiologists, publishing articles of scientific excellence in radiology and radiation oncology. Manuscripts are judged on the basis of their contribution of original data and ideas or interpretation. All articles are peer reviewed.
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