Impact of a reduction in follow-up frequency on life expectancy in uterine cervical cancer patients
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ORIGINAL ARTICLE
Impact of a reduction in follow‑up frequency on life expectancy in uterine cervical cancer patients Yuri Matsumoto1 · Seiji Mabuchi1 · Fumiaki Isohashi2 · Naoko Komura1 · Kazuhiko Ogawa2 · Tadashi Kimura1 Received: 25 November 2019 / Accepted: 20 February 2020 © Japan Society of Clinical Oncology 2020
Abstract Background The appropriate interval of post-treatment follow-up appointments for uterine cervical cancer is unclear. The aim of this study was to investigate the impact of reducing the frequency of post-treatment follow-up examinations on life expectancy and medical expenses in cervical cancer patients. Methods Cervical cancer patients who were treated with radiotherapy between 2008 and 2017, underwent a less frequent follow-up program, and subsequently developed recurrent disease were included in consecutive group (CG). Non-randomized groups of cervical cancer patients who underwent a frequent follow-up program after radiotherapy between 1997 and 2007, and subsequently developed recurrent disease were also identified through a chart review and served as a comparison group (primary group [PG]). Clinical data regarding the primary disease, follow-up, recurrence, and survival were collected. Univariate and multivariate analyses of predictors of survival were performed. Results A total of 263 recurrent cervical cancer patients (PG: 154, CG: 109) were included in the current study. A reduction in follow-up frequency of up to 40% did not increase the frequency of symptomatic recurrence (PG: vs. CG: 31.2% vs. 35.8%, p = 0.43) or reduce the median overall survival periods of recurrent cervical cancer patients (PG vs. CG: 32 months vs. 36 months, p = 0.15). However, the reduction in the follow-up frequency significantly reduced follow-up costs. Conclusion Reducing the frequency of follow-up by up to 40% did not result in shorter overall survival compared with a conventional follow-up program. The results of this study provide a rationale for future studies investigating the optimal follow-up schedule for patients with cervical cancer. Keywords Follow-up frequency · Survival · Cost · Cervical cancer · Radiotherapy
Introduction
Yuri Matsumoto, Seiji Mabuchi and Fumiaki Isohashi are equally contributed to this study. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10147-020-01641-w) contains supplementary material, which is available to authorized users. * Seiji Mabuchi [email protected]‑u.ac.jp 1
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2‑2 Yamadaoka, Suita, Osaka 565‑0871, Japan
Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2‑2 Yamadaoka, Suita, Osaka 565‑0871, Japan
2
It is estimated that approximately 30% of patients with invasive cervical cancer will develop recurrent or persistent disease after primary treatment [1]. With rare exceptions, patients with recurrent or advanced cervical cancer have a very poor prognosis, with a reported 2-year surv
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