Value of Routine Pelvic Examination in the Follow-Up of Patients Receiving Adjuvant Radiation Therapy for Endometrial Cancer: An Australian Tertiary-Centre Experience
- Author(s)
- Knox, MC; Salkeld, A; Brand, A; Herbst, U; Chard, J; Thiruthaneeswaran, N;
- Journal Title
- Journal of Medical Imaging and Radiation Oncology
- Publication Type
- Online publication before print
- Abstract
- 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.
- Keywords
- endometrial cancer; follow‐up; patient experience; rational healthcare; surveillance
- Department(s)
- Radiation Oncology
- Publisher's Version
- https://doi.org/10.1111/1754-9485.13864
- Open Access at Publisher's Site
https://doi.org/10.1111/1754-9485.13864- Terms of Use/Rights Notice
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Creation Date: 2025-06-02 04:28:19
Last Modified: 2025-06-02 04:28:43