Patient-initiated follow-up in women with early-stage endometrial cancer: a long-term follow-up of the OPAL trial

M. C. Rulanda*, O. Mogensen, P. T. Jensen, D. G. Hansen, C. Wu, M. M. Jeppesen


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Objective: A long-term follow-up of the OPAL trial to compare the effect of patient-initiated (PIFU) versus hospital-based (HBFU) follow-up on fear of cancer recurrence (FCR), quality of life (QoL) and healthcare use after 34 months of follow-up. Design: Pragmatic, multicentre randomised trial. Setting: Four Danish departments of gynaecology between May 2013 and May 2016. Population: 212 women diagnosed with stage I low-intermediate risk endometrial carcinoma. Methods: The control group attended HBFU with regular outpatient visits (i.e., 8) for 3 years after primary treatment. The intervention group underwent PIFU with no prescheduled visits but with instructions about alarm symptoms and options of self-referral. Main outcome measures: The endpoints were FCR as measured by the Fear of Cancer Recurrence Inventory (FCRI) and QoL as measured by the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire C-30 (EORTC QLQ C-30), and healthcare use as measured by questionnaires and chart reviews after 34 months of follow-up. Results: FCR decreased from baseline to 34 months in both groups and no difference was found between allocations (difference −6.31 [95% confidence interval −14.24 to 1.63]). QoL remained stable with no difference in any domains between the two arms at 34 months using a linear mixed model analysis. The use of healthcare was significantly lower in the PIFU group (P < 0.01). Conclusion: Patient-initiated follow-up is a valid alternative to hospital-based follow-up for people who have been treated for endometrial cancer and have low risk of recurrence.

TidsskriftBJOG: An International Journal of Obstetrics and Gynaecology
Udgave nummer13
Sider (fra-til)1593-1601
StatusUdgivet - dec. 2023

Bibliografisk note

Funding Information:
The research for this article was financially supported by the Danish Cancer Society, (grant no. R94‐A5679 Rp7423), the National Research Centre of Cancer Rehabilitation, University of Southern Denmark, the Region of Southern Denmark (grant no. 13/6697) and Odense University Hospital (grant no. 12/26914), Independent Research Fund Denmark (grant no. 0168‐00020B). The funders of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report.


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