Vaginal vault cytology in the routine follow-up of patients treated for endometrial carcinoma: Is it useful?

Abstract

Routine follow-up visits and vault cytology following treatment for endometrial carcinoma generates a considerable workload and takes up valuable resources. A review is needed to evaluate the usefulness of this practice. Eighty six patients treated and followed-up from January, 1987 to July, 1994 were reviewed. The standard follow-up protocol consisted of physical assessment and vault cytology every 1 to 2 months for the first 2 years, every 3 months for the third year and every 6 months thereafter for at least 5 years. Recurrences were defined as histologically proven disease after a 3-month disease free interval. Fourteen patients (17%) developed recurrences. Two of the 14 patients (14%) had local recurrences in the pelvis. Only 3 of these recurrences were detected during routine follow-up. Vault cytology was negative in all patients with recurrences even when the recurrence occurred locally in the pelvis. Traditional surveillance protocols were ineffective in the detection of recurrences. Vault cytology was particularly ineffective. It was calculated that 1 recurrence was detected for every 606 visits. In this age of budgetary constraints, alternative follow-up protocols should be explored.