Association between adherence to posttreatment National Comprehensive Cancer Network (NCCN) surveillance guidelines and detection of recurrent uterine cancer

• Published in: Gynecologic oncology 2024-02, Vol.181, p.8-11
• Main Authors: Mayer, Christopher M., O'Connor, Reed M., Do, Anthony T., Cerda, Victoria R., Wang, Stephanie M., Scott, Marla E., Li, Andrew J., Rimel, B.J., Manuel, Michael R., Taylor, Kristin N., Kim, Kenneth H.
• Format: Article
• Language: English
• Subjects: Adherence; Recurrence; Surveillance; Uterine cancer
• ISSN: 0090-8258; 1095-6859; 1095-6859
• DOI: 10.1016/j.ygyno.2023.11.024

To identify correlations between disease recurrence and adherence to NCCN posttreatment surveillance guidelines in patients who develop recurrent uterine cancer. Retrospective analysis identified patients (n = 60) with recurrent uterine cancer and at least one surveillance visit with a gynecologic oncologist between 2011 and 2020. Adherence to NCCN guidelines and details of recurrence were recorded. Recurrent uterine cancer was identified in 60 patients with an average time to recurrence (TTR) of 25 months. Of those, 39 (65%) were adherent to NCCN surveillance guidelines and 36 (60%) were symptomatic at the time of recurrence diagnosis. Asymptomatic recurrence was diagnosed by imaging in 11 (46%), physical exam in 7 (29%), and blood work in 6 (25%) patients. Patients who were adherent to NCCN guidelines were diagnosed with recurrence on average 11 months earlier (p = 0.0336). Adherence was an independent predictor of TTR for all patients regardless of symptoms. There was no significant effect of age, race, primary language, or stage of disease on adherence. Adherence to NCCN posttreatment surveillance guidelines for uterine cancer is independently associated with an earlier diagnosis of recurrence. •Many patients are not adherent to NCCN surveillance guidelines at time of recurrence detection.•Physical exam is an important for detecting uterine cancer recurrence.•Non-NCCN directed imaging detected almost half of asymptomatic recurrences.•Asymptomatic recurrence is detected earlier in patients who adhere to NCCN posttreatment surveillance guidelines.