A national, prospective observational study of first recurrence after primary treatment for gynecological cancer in Norway.

Autor:	Vistad I; Department of Obstetrics and Gynecology, Sørlandet Hospital, Kristiansand, Norway., Bjørge L; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.; Departments of Global Public Health and Primary Care and Clinical Medicine, Haukeland University Hospital, Bergen, Norway.; Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway., Solheim O; Department of Gynecologic Oncology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway., Fiane B; Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway., Sachse K; Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway., Tjugum J; Department of Obstetrics and Gynecology, Førde Central Hospital, Førde, Norway., Skrøppa S; Department of Obstetrics and Gynecology, Vestfold Hospital Trust, Tønsberg, Norway., Bentzen AG; Department of Gynecologic Oncology, University Hospital of Tromsø, Tromsø, Norway., Stokstad T; Department of Obstetrics and Gynecology, St. Olav's University Hospital, Trondheim, Norway., Iversen GA; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway., Salvesen HB; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway., Kristensen GB; Department of Gynecologic Oncology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway.; Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway., Dørum A; Department of Gynecologic Oncology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway.
Jazyk:	angličtina
Zdroj:	Acta obstetricia et gynecologica Scandinavica [Acta Obstet Gynecol Scand] 2017 Oct; Vol. 96 (10), pp. 1162-1169.
DOI:	10.1111/aogs.13199
Abstrakt:	Introduction: Gynecological cancer patients are routinely followed up for five years after primary treatment. However, the value of such follow up has been debated, as retrospective studies indicate that first recurrence is often symptomatic and occurs within two to three years of primary treatment. We prospectively investigated time to first recurrence, symptoms at recurrence, diagnostic procedures, and recurrence treatment in gynecological cancer patients after primary curative treatment. Material and Methods: Clinicians from 21 hospitals in Norway interviewed 680 patients with first recurrence of gynecological cancer (409 ovarian, 213 uterine, and 58 cervical cancer patients) between 2012 and 2016. A standardized questionnaire was used to collect information on self-reported and clinical variables. Results: Within two years of primary treatment, 72% of ovarian, 64% of uterine, and 66% of cervical cancer patients were diagnosed with first recurrence, and 54, 67, and 72%, respectively, had symptomatic recurrence. Of symptomatic patients, 25-50% failed to make an appointment before their next scheduled follow-up visit. Computer tomography was the most common diagnostic procedure (89% of ovarian, 76% of uterine, and 62% of cervical cancer patients), and recurrence treatment in terms of chemotherapy was most frequently planned (86% of ovarian, 46% of uterine, and 62% of cervical cancer patients). Conclusions: A majority of patients experienced symptomatic recurrence, but many patients failed to make an appointment earlier than scheduled. Most first recurrences occurred within two years of primary treatment; the mean annual incidence rate for years 3-5 after primary treatment was <7%. New models for follow up of gynecological cancer patients could be considered. (© 2017 Nordic Federation of Societies of Obstetrics and Gynecology.)
Databáze:	MEDLINE
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