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Original research
Surveillance patterns of cervical cancer patients treated with conization alone
  1. Silvana Pedra Nobre1,
  2. Varvara Mazina2,
  3. Alexia Iasonos3,
  4. Qin C Zhou3,
  5. Yukio Sonoda1,
  6. Ginger Gardner1,
  7. Kara Long-Roche1,
  8. Mario M Leitao1,
  9. Nadeem R Abu-Rustum1 and
  10. Jennifer J Mueller1
  1. 1 Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
  2. 2 Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
  3. 3 Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
  1. Correspondence to Dr Jennifer J Mueller, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; muellerj{at}mskcc.org

Abstract

Objectives To determine surveillance patterns of stage I cervical cancer after cervical conization.

Methods A 25-question electronic survey was sent to members of the Society of Gynecologic Oncology. Provider demographics, surveillance during year 1, years 1–3, and >3 years after cervical conization, use of pelvic examination, cytology, Human papillomavirus testing, colposcopy, and endocervical curettage were queried. Data were analyzed.

Results 239/1175 (20.1%) responses were collected over a 5-week study period. All providers identified as gynecologic oncologists. During year 1, 66.7% of providers perform pelvic examination and 37.1% perform cytology every 3 months. During years 1–3, 61.6% perform pelvic examination and 46% perform cytology every 6 months. At >3 years, 54.4% perform pelvic examination every 6 months and 43% perform annual pelvic examination. 66.7% of respondents perform cytology annually, and 51.9% perform annual Human papilloma virus testing. 85% of providers do not offer routine colposcopy and 60% do not offer endocervical curettage at any point during 5-year follow-up. 76.3% of respondents screen patients for Human papilloma virus vaccination.

Conclusions To date, there are no specific surveillance guidelines for patients with stage I cervical cancer treated with cervical conization. The most common surveillance practice reported is pelvic examination with or without cytology every 3 months in year 1 and every 6 months thereafter. However, wide variation exists in visit frequency, cytology, and Human papillomavirus testing, and there is a clear trend away from using colposcopy and endocervical curettage. These disparate surveillance practices indicate a need for well-defined, uniform surveillance guidelines.

  • cervical cancer
  • surgical oncology
  • surgical procedures, operative

https://doi.org/10.1136/ijgc-2020-001338

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    Footnotes

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    • Contributors Silvana Pedra Nobre: conception and design; analysis and interpretation of data; drafting of article; revising article critically for important intellectual content; final approval of version to be published; agrees to be accountable for all aspects of the work. Varvara Mazina: conception and design; analysis and interpretation of data; drafting of article; final approval of version to be published; agrees to be accountable for all aspects of the work. Alexia Iasonos: analysis and interpretation of data; drafting of article; final approval of version to be published; agrees to be accountable for all aspects of the work. Qin C. Zhou: analysis and interpretation of data; final approval of version to be published; agrees to be accountable for all aspects of the work.Yukio Sonoda: Interpretation of data; revising article critically; final approval of version to be published; agrees to be accountable for all aspects of the work. Ginger J. Gardner: interpretation of data; revising article critically; final approval of version to be published; agrees to be accountable for all aspects of the work. Kara Long Roche: interpretation of data; revising article critically; final approval of version to be published; agrees to be accountable for all aspects of the work. Mario M. Leitao, Jr.: interpretation of data; revising article critically; final approval of version to be published; agrees to be accountable for all aspects of the work. Nadeem R. Abu-Rustum: interpretation of data; revising article critically; final approval of version to be published; agrees to be accountable for all aspects of the work. Jennifer J. Mueller: conception and design; analysis and interpretation of data; drafting of article; revising article critically for important intellectual content; final approval of version to be published; agrees to be accountable for all aspects of the work.

    • Funding This study was funded in part through the NIH/NCI Support Grant P30 CA008748.

    • Competing interests Dr. Abu-Rustum reports grants from Stryker/Novadaq, grants from Olympus, grants from GRAIL, outside the submitted work. Dr. Iasonos reports consultant and personal fees from Mylan, outside the submitted work. Dr. Leitao is a consultant for Intuitive Surgical Inc., outside the submitted work. Dr. Long Roche reports other (travel expenses to a Survivorship Conference, where she spoke) from Intuitive Surgical Inc., outside the submitted work.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information.