Monitoring

The goal of monitoring is to detect recurrence as soon as it occurs; however, there is no evidence that this impacts on survival, and it may worsen anxiety and lead to expensive investigations and over-treatment.

Most recurrences (65% to 85%) occur within 3 years of treatment and are symptomatic.[9]

Clinical follow-up should focus on signs and symptoms suggestive of recurrence, such as vaginal bleeding, abdominal or pelvic pain, persistent cough, unexplained weight loss, and new-onset neurological symptoms.

The clinician can use the following schedule for follow-up:[83]

  • Physical examination every 3 to 6 months for 2 to 3 years

  • Then every 6 to 12 months until year 5

  • Then annually

Imaging based on symptoms or examination findings that suggest recurrence.

Vaginal cytology, serum CA-125, and annual chest x-ray have no proven role in follow-up.[270][271]

Patient-initiated or nurse-led follow-up may be an option for some low-risk patients.[9][96]​​​

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