Society of Gynecologic Oncology

View all recommendations from this society

Released October 31, 2013

Imaging for cancer surveillance in women with gynecologic cancer, specifically ovarian, endometrial, cervical, vulvar and vaginal cancer should be driven by symptoms/signs.

Avoid routine imaging for patients with a history of ovarian, endometrial, cervical, vulvar and vaginal cancer. Imaging in the absence of symptoms,
abnormal physical exam findings and/or rising tumor markers for gynecologic cancers has shown low yield in detecting recurrence or
impacting overall survival.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The Society of Gynecologic Oncology (SGO) created a “Cost of Care” workgroup in response to the ABIM Foundation’s Choosing Wisely® campaign. Workgroup members are comprised of the Society’s clinical practice committee that is made up of gynecologic oncologists, medical oncologists, nurse practitioners, pharmacists and other allied health providers. A literature review was conducted to identify areas of overutilization or unproven clinical benefit and areas of underutilization in the presence of evidence-based guidelines. The workgroup then evaluated these data and presented a list of five topics to the membership of the clinical practice committee and then to the SGO Board of Directors for approval. The five selected interventions were agreed upon as the most important components for women with gynecologic malignancies and their providers to consider.

SGO’s disclosure and conflict of interest policy can be found at www.sgo.org.

Sources

Sartori E, Pasinetti B, Carrara L, Gambino A, Odicino F, Pecorelli S. Pattern of failure and value of follow up procedures in endometrial and cervical cancer patients. Gynecol Oncol. 2007;107:S241–7.

Berchuck A, Anspach C, Evans AC, Soper JT, Rodriguez GC, Dodge R, Robboy S, Clarke-Pearson DL. Postsurgical surveillance of patients with FIGO stage I/II endometrial adenocarcinoma.Gynecol Oncol. 1995;59:20–4.

Bhosale P, Peungjesada S, Wei W, Levenback CF, Schmeler K, Rohren E, Macapinlac HA, Iyer RB. Clinical utility of positron emission tomography/computed tomography in the evaluation of suspected recurrent ovarian cancer in the setting of normal CA125 levels. Int J Gynecol Cancer. 2010;20:936–44.

Havrilesky LJ, Wong TZ, Alvarez Secord A, Berchuck A, Clarke-Pearson DL, Jones E. The role of PET scanning in the detection of recurrent cervical cancer. Gynecol Oncol. 2003;90:186–90.

Rimel BJ, Ferda A, Erwin J, Dewdney SB, Seamon L, Gao F, DeSimone C, Cotney KK, Huh W, Massad LS. Cervicovaginal cytology in the detection of recurrence after cervical cancer treatment. Obstet Gynecol. 2011;118:548–53.