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Objective There are few studies analyzing surveillance for Type II endometrial cancer recurrence. Our objective was to determine the types of post treatment surveillance tests performed in our institution and the efficacy of these tests in detecting recurrence in type II endometrial cancer patients. Methods One hundred and thirty six cases of type II endometrial cancers at Cedars-Sinai Medical Center from January of 2000 to August of 2011 were identified and 106 patients met inclusion criteria. Medical charts were reviewed for surveillance methods and number of follow up visits. For patients who underwent a recurrence of disease, the surveillance method utilized for detection was documented. Results Forty-seven of the 106 (44%) patients developed recurrence with a mean progression free interval of 11 months. All patients had a history and physical at each surveillance visit, 78% had Pap testing, 57% had CA-125 levels drawn, 59% had CT (computed tomography) scans done, 6% had PET (positron emission tomography) scans done for surveillance. In our cohort, recurrence was detected by symptoms in 16, by CA-125 in 11, by physical exam in 7, by CT scan in 12, and by PET scan in one patient. No patients had recurrence detected by vaginal cytology. Conclusions Although performed in the majority of patients, Pap testing did not detect any recurrences within this cohort. History and physical exam detected the most recurrences. These findings suggest that educating patients about relevant symptoms and performing thorough follow-up exams may be the most important aspects of detecting type II endometrial cancer recurrence. © 2013 Elsevier Inc.

Squamous carcinoma in situ of the vulva in 81 patients treated at the Vancouver General Hospital between 1970 and 1980 were reviewed. The patients were assigned to one of two study periods, 1970–1974 or 1975–1980, for the purposes of comparison. Forty-two percent of patients seen in the latter study period were less than 35 years of age, as contrasted to only 14% of patients in the earlier time period. Similar trends were noted in the frequency of involvement of the genital tract by multifocal squamous neoplasia with 51 and 25% of patients having this problem in the two time periods. Those patients under 30 years of age were at particular risk for multiple genital site involvement. Vulvar pruritis or irritation was the most common method of presentation. Abnormalities of cervical or vaginal cytology led to the diagnosis of vulvar carcinoma in 15% of patients. Younger women tended to present with multicentric, often pigmented lesions, whereas unifocal lesions were more common in the older age groups. Treatment methods varied little between the two study periods. Treatment should be individualized and conservative, particularly in younger women until the true neoplastic potential of these lesions is better known.