[Experiences with second-look curettage following irradiated primary endometrial cancer. Consequences for tumor follow-up].

A report is given about 207 second-look curettages 9-12 months after radiotherapy of carcinoma endometrii. In 22.7% of the cases clinical symptoms of a recurrent disease already have been observed. In 18.4% second-look curettage could not be performed because of complete obliteration of the cervical canal. Perforations occurred in 5.3%. A positive histologic result was found in 17.2%. Only 64% of all recurrent diseases 24 months after primary irradiation were detected by means of second-look curettage. Most interesting are the cases with obliteration of the cervical canal: 37 out of 38 patients showed local recidivation in the following 5 years. Regular intrauterine exfoliation smears in tumour follow-up of primary irradiated endometrial carcinomas are suggested. If this is not possible because of an obliterated cervical canal, second-look curettage must be performed. In this manner not only recidivation can be detected, but obliterations of the cervical canal with consecutive recurrent disease can also be prevented.