Didactics-Surveillance for Survivorship care in Gynecological Oncology

Video Transcription

Video Summary

In this video, the speaker discusses surveillance activities for detecting and managing recurrent gynecologic cancers. The focus is on cost-effective practices that aim to decrease morbidity and improve survival outcomes. The speaker references two articles, including a white paper from the SGO in 2017.<br /><br />For endometrial cancer, the most important surveillance tool is history and physical exams, which have a detection rate for recurrence of over 80%. Vaginal bleeding is a common symptom. Low-risk patients require follow-up every six months for the first year to two, while high-risk patients need more frequent follow-up. Cytology and routine imaging are not recommended.<br /><br />For uterine sarcomas, surveillance differs based on subtypes. Follow-up for germ cell tumors and sex cord stromal tumors includes physical exams and tumor marker evaluations. Routine imaging is not recommended for germ cell tumors unless tumor markers are not present.<br /><br />For ovarian cancer, history and physical exams are crucial. CA-125 tests have good specificity but limited sensitivity. Routine imaging is not recommended for asymptomatic patients, but if recurrence is suspected, imaging is warranted.<br /><br />For cervical cancer, history and physical exams are vital, with symptoms such as pain, lymphedema, vaginal bleeding, and new discharge. Low-risk patients require follow-up every six months, while high-risk patients need more frequent follow-up. Routine pap smears are not recommended, but cytology may be performed if necessary.<br /><br />For vaginal and vulvar cancer, symptoms such as itching, lumps, and lesions are important indicators. Follow-up includes history and physical exams, as well as pap smears.<br /><br />The video emphasizes the importance of history and physical exams in detecting recurrence, with additional tests and imaging recommended when necessary. The sensitivity of these methods varies for different types of gynecologic cancers.

Asset Subtitle

Gabrielle Hawkins
June 2020

Keywords

surveillance activities

recurrent gynecologic cancers

history and physical exams

routine imaging

pap smears