1. Early recognition and prompt management of treatment related complications
2. Early detection of persistent or recurrent disease
3. Collection of meaningful data regarding the efficacy of existing treatment polices and their complications so that any appropriate modifications can be instituted.
4. If suspected or known Lynch syndrome – screen for breast and colorectal cancers. Referral to Hereditary Screening Program highly recommended.
Stage I low risk (Stage IA/IB G1 AND 2)
These patients are at low risk of recurrence (<5%), which is most likely to occur within the first 2 years after primary treatment. The most likely site of recurrence is the vaginal vault, therefore these patients need to be counseled about vaginal bleeding. Their follow-up care can be provided by their referring physician. They do not need routine bloodwork, pap smear, or imaging, unless indicated by symptoms or signs on examination.
Years 1 and 2: every 6 months
Years 3+: annually
Stage I/II intermediate risk (Stage IA/IB Grade 3; Stage IC and IIA Grades 1 and 2; Stage IIA Grade 3 <50% MI)
These patients are still at low risk of recurrence (5-10%), which is most likely to occur within the first 2-3 years after primary treatment. They can recur in the pelvis/vault, but some will recur distantly. These patients need to be counseled about vaginal bleeding, pelvic pain, bloating, increased abdominal girth. They can be seen at BCCA for the first 2 years, then transferred to the care of their referring physician for the next 3 years.
Year 1: every 3 months
Year 2: every 6 months
Year 3+: annually
Stage I/II “high risk” (Stage IC Grade 3; Stage IIA Grade 3 if >50% MI, Stage IIB, any Stage I/II UPSC, CCC, MMMT)
These patients are at high risk of recurrence (>25%), which may be distant or Locoregional. Their recurrences are also most likely to occur within the first 2-3 years after primary treatment.
Year 1: every 3 months
Year 2: every 4 months
Year 3-5: every 6 months
Years 5+: annually
Advanced stage (Stage III/IV)
These patients generally have incurable disease. Their recurrence risk is >50%.
Year 1: every 3 months
Year 2: every 4 months
Year 3-5: every 6 months
Years 5+: annually