Poster Presentation Clinical Oncology Society of Australia 2014 Annual Scientific Meeting

Development of an evidence based symptom checklist for detecting symptoms of recurrence in women with endometrial cancer (#314)

Audra de Witt 1 , Andreas Obermair 2 , Monika Janda 3
  1. Cancer Epidemiology and Health Services Division, Menzies School of Health Research, Brisbane, QLD, Australia
  2. Cancer Care Services, Royal Brisbane and Women's Hospitals, Queensland Centre for Gynaecological Cancer, Brisbane, QLD, Australia
  3. Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia

Aims: There is a need to explore alternative models of follow-up care for women diagnosed with endometrial cancer.  Currently, patients are commonly followed up using clinic based examinations for a five year period.  However, the effectiveness of this follow-up plan in detecting cancer recurrence has been a contentious issue among some health professionals due to lack of supporting evidence.   Asking women regularly about their possible symptoms may be an alternative option.  This study aimed to identify currently available symptom checklists, determine the comprehensiveness of identified checklists, and generate an updated list of symptoms that potentially may be associated with a recurrence of endometrial cancer for future testing.

Methods:  A systematic review of the literature was conducted extracting; routine follow-up schedules, proportions of patients that were symptomatic and asymptomatic, symptoms of recurrence and prevalence of these symptoms at recurrence.

Results: Three previous symptom checklists and 12 retrospective studies were identified as meeting the selection criteria.  The average rate of recurrence across the identified studies was 13% (range 3% to 19%). The proportion of patients identified with a symptomatic recurrence varied across the studies with the overall average rate of 67% (range 41% to 91%).  Vaginal bleeding (25%), pain [not further described] (16%) and abdominal pain and/or discomfort and swelling (15%) were the most commonly reported symptoms in this study, and combined, represented 56% of the total reported symptoms.  This review identified an additional 24 symptoms to the previously identified 14 common symptoms from the three previous checklists. This included vaginal discharge, leg pain, constipation and headache.

Conclusion: The newly developed symptom checklist provides an update to the previous ones by an additional 24 symptoms.  It will be used in a prospective cohort study to assess whether it is sensitive and specific enough to identify recurrence compared to current standard follow-up examinations.