TY - JOUR
T1 - Surveillance procedures for patients for cervical carcinoma
T2 - A review of the literature
AU - Zanagnolo, Vanna
AU - Minig, Lucas Alfonso
AU - Gadducci, Angelo
AU - Maggino, Tiziano
AU - Sartori, E.
AU - Zola, Paolo
AU - Landoni, Fabio
PY - 2009/4
Y1 - 2009/4
N2 - Cervical cancer is still one of the most common malignancies in women. Treatment for cervical cancer is very successful, especially in early stage. However, some patients will experience recurrence. Primary purpose of follow-up programs is early detection of recurrence disease that should be more likely to be amenable to treatment, thereby improving the clinical outcome. Although, in the literature, most studies have shown that the surveillance programs did not improve the clinical outcome of patients with diagnosis of recurrence, this clinical practice is regarded as traditional management. The use of Papanicolaou tests to detect recurrent cervical cancer is not sufficiently justified. The assessment of tumor markers such as squamous cell carcinoma antigen could be useful. Imaging techniques are important for the detection and assessment of recurrent disease. The role of chest radiographs to detect asymptomatic recurrence in patients treated for cervical carcinoma remains controversial. Detection of a new abnormal mass or the changes in the size of a known lesion caused by cancer growth and the determination of the extent of recurrence with computed tomography and magnetic resonance imaging may provide clinical assistance in selection of optimal therapy. The fluoro-2-deoxy-glucose-positron emission tomography for surveillance only shows 80% of specificity and accuracy with negative predictive value of 100%. Integrated fluoro-2-deoxy-glucose- positron emission tomography/computed tomography provides precise anatomic localization of suspicious areas and therefore a better diagnostic interpretation with a possible impact on disease-free survival as well. In conclusion, our review confirms the need of prospective studies to compare the effectiveness of different follow-up regimens measuring as outcome overall survival and quality of life parameters.
AB - Cervical cancer is still one of the most common malignancies in women. Treatment for cervical cancer is very successful, especially in early stage. However, some patients will experience recurrence. Primary purpose of follow-up programs is early detection of recurrence disease that should be more likely to be amenable to treatment, thereby improving the clinical outcome. Although, in the literature, most studies have shown that the surveillance programs did not improve the clinical outcome of patients with diagnosis of recurrence, this clinical practice is regarded as traditional management. The use of Papanicolaou tests to detect recurrent cervical cancer is not sufficiently justified. The assessment of tumor markers such as squamous cell carcinoma antigen could be useful. Imaging techniques are important for the detection and assessment of recurrent disease. The role of chest radiographs to detect asymptomatic recurrence in patients treated for cervical carcinoma remains controversial. Detection of a new abnormal mass or the changes in the size of a known lesion caused by cancer growth and the determination of the extent of recurrence with computed tomography and magnetic resonance imaging may provide clinical assistance in selection of optimal therapy. The fluoro-2-deoxy-glucose-positron emission tomography for surveillance only shows 80% of specificity and accuracy with negative predictive value of 100%. Integrated fluoro-2-deoxy-glucose- positron emission tomography/computed tomography provides precise anatomic localization of suspicious areas and therefore a better diagnostic interpretation with a possible impact on disease-free survival as well. In conclusion, our review confirms the need of prospective studies to compare the effectiveness of different follow-up regimens measuring as outcome overall survival and quality of life parameters.
KW - Cervical cancer recurrence
KW - Computed tomography
KW - FDG-positron emission tomography/computed tomography
KW - Follow-up
KW - Magnetic resonance imaging
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U2 - 10.1111/IGC.0b013e3181a130f3
DO - 10.1111/IGC.0b013e3181a130f3
M3 - Article
C2 - 19407551
AN - SCOPUS:68149181737
VL - 19
SP - 306
EP - 313
JO - International Journal of Gynecological Cancer
JF - International Journal of Gynecological Cancer
SN - 1048-891X
IS - 3
ER -