Radiography Chest Chest radiographs have been advocated for the detection of asymptomatic chest recurrences, often on a semi-annual or annual basis. However, the rate of detection for asymptomatic chest recurrences found on chest radiographs ranges only from 0% to 20% [87,90]. Thus, this procedure may not be appropriate for this group. US Pelvis Transvaginal Because many of the recurrences are detected during the physical examination, the use of routine pelvic US is not advocated [21,87]. US Pelvis Transabdominal Because many of the recurrences are detected during the physical examination, the use of routine pelvic US is not advocated [21,87]. US Abdomen Because many of the recurrences are detected during the physical examination the use of abdominal US is not advocated [21,87]. Evaluation and Follow-Up of Endometrial Cancer Variant 5: Surveillance of asymptomatic patients with treated high-risk endometrial cancer. Most patients are cured following primary treatment; however, approximately 25% to 30% of patients in this subgroup may develop recurrent disease [91]. Typical metastatic sites of recurrent EC are local pelvic recurrence, pelvic and para-aortic lymph nodes, peritoneum, and lungs [17]. Atypical metastatic sites are extra-abdominal lymph nodes, liver, adrenals, brain, bones, and soft-tissue [17]. Vaginal bleeding is a common symptom of a local recurrence. In patients diagnosed with a distant recurrence, symptoms such as coughing, pain, lethargy, weight loss, or headaches are present in up to 70% of cases [19,20]. In one reported study, the combination of physical examination alone or in combination with symptoms resulted in detection rates of recurrence that exceeded 80% [21]. CT Chest, Abdomen, and Pelvis The evidence supporting routine CT surveillance following EC is insufficient. Even in type II EC, CT scans detected only 15% of recurrences [92].
Pretreatment Evaluation and Follow Up of Endometrial Cancer. Radiography Chest Chest radiographs have been advocated for the detection of asymptomatic chest recurrences, often on a semi-annual or annual basis. However, the rate of detection for asymptomatic chest recurrences found on chest radiographs ranges only from 0% to 20% [87,90]. Thus, this procedure may not be appropriate for this group. US Pelvis Transvaginal Because many of the recurrences are detected during the physical examination, the use of routine pelvic US is not advocated [21,87]. US Pelvis Transabdominal Because many of the recurrences are detected during the physical examination, the use of routine pelvic US is not advocated [21,87]. US Abdomen Because many of the recurrences are detected during the physical examination the use of abdominal US is not advocated [21,87]. Evaluation and Follow-Up of Endometrial Cancer Variant 5: Surveillance of asymptomatic patients with treated high-risk endometrial cancer. Most patients are cured following primary treatment; however, approximately 25% to 30% of patients in this subgroup may develop recurrent disease [91]. Typical metastatic sites of recurrent EC are local pelvic recurrence, pelvic and para-aortic lymph nodes, peritoneum, and lungs [17]. Atypical metastatic sites are extra-abdominal lymph nodes, liver, adrenals, brain, bones, and soft-tissue [17]. Vaginal bleeding is a common symptom of a local recurrence. In patients diagnosed with a distant recurrence, symptoms such as coughing, pain, lethargy, weight loss, or headaches are present in up to 70% of cases [19,20]. In one reported study, the combination of physical examination alone or in combination with symptoms resulted in detection rates of recurrence that exceeded 80% [21]. CT Chest, Abdomen, and Pelvis The evidence supporting routine CT surveillance following EC is insufficient. Even in type II EC, CT scans detected only 15% of recurrences [92].