Updates to post-treatment surveillance after curative intent treatment for patients with gynecologic cancers: A Society of Gynecologic Oncology clinical practice statement

Gynecologic malignancies accounted for ∼15 % of new cancer cases and cancer survivors in 2022. Advances in cancer care are expected to improve outcomes, and the growth in survivorship is expected to increase by over 25 % in the next several years. After completion of primary therapy, follow-up care is designed to monitor patients for recurrence; however, the evidence for surveillance recommendations is weak and often based on retrospective studies, resulting in wide variability in clinical practice. Therefore, understanding the most clinically efficient tools to detect cancer recurrence, particularly when interventions can lead to survival and/or quality of life improvements, is a priority. Currently, symptom review and physical examination are reportedly the most effective methods to detect recurrence across gynecologic tumor types. Interestingly, tests such as vaginal cytology, which have negligible benefit in recurrence detection, are still frequently utilized in the posttreatment evaluation of patients. Similarly, imaging is often routinely used without proven benefit; however, it is important to note that imaging may play a role in specific settings. Lastly, incorporating novel serum biomarkers and emerging tests, such as circulating tumor DNA (ctDNA), requires additional studies. This article is designed to provide an update on best practices for surveillance in gynecologic cancer patients after curative intent primary therapy.