The role of asymptomatic screening in the detection of recurrent ovarian cancer

M.T. Richardson; S. Routson; A. Karam; O. Dorigo; K. Levy; M. Renz; E.J. Diver

Gynecologic Oncology Reports (Aug 2020)

The role of asymptomatic screening in the detection of recurrent ovarian cancer

M.T. Richardson,
S. Routson,
A. Karam,
O. Dorigo,
K. Levy,
M. Renz,
E.J. Diver

Affiliations

M.T. Richardson: Stanford Women's Cancer Center, Stanford Cancer Institute, Division of Gynecologic Oncology, Stanford University School of Medicine, Stanford, CA, USA
S. Routson: Stanford Women's Cancer Center, Stanford Cancer Institute, Division of Gynecologic Oncology, Stanford University School of Medicine, Stanford, CA, USA
A. Karam: Stanford Women's Cancer Center, Stanford Cancer Institute, Division of Gynecologic Oncology, Stanford University School of Medicine, Stanford, CA, USA
O. Dorigo: Stanford Women's Cancer Center, Stanford Cancer Institute, Division of Gynecologic Oncology, Stanford University School of Medicine, Stanford, CA, USA
K. Levy: Stanford Women's Cancer Center, Stanford Cancer Institute, Division of Gynecologic Oncology, Stanford University School of Medicine, Stanford, CA, USA
M. Renz: Stanford Women's Cancer Center, Stanford Cancer Institute, Division of Gynecologic Oncology, Stanford University School of Medicine, Stanford, CA, USA
E.J. Diver: Corresponding author at: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford University, 900 Blake Wilbur Drive, Palo Alto, CA 94304, USA.; Stanford Women's Cancer Center, Stanford Cancer Institute, Division of Gynecologic Oncology, Stanford University School of Medicine, Stanford, CA, USA

Journal volume & issue: Vol. 33
p. 100595

Abstract

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Objective: To investigate the utility of asymptomatic screening, including CA-125, imaging, and pelvic exam, in the diagnosis and management of recurrent ovarian cancer. Methods: Women with ovarian cancer whose cancer recurred after remission were categorized by first method that their provider suspected disease recurrence: CA-125, imaging, symptoms, or physical exam. Differences in clinicopathologic, primary treatment characteristics, and outcomes data including secondary cytoreductive surgery (SCS) outcome and overall survival (OS) were collected. Results: 102 patients were identified at our institution from 2003 to 2015. 20 recurrences were detected by symptoms, while 62 recurrences were diagnosed first by asymptomatic rise in CA-125, 5 by pelvic exam, and 15 by imaging in the absence of known exam abnormality or rise in CA-125.Mean time to recurrence was 18.9 months, and median survival was 45.8 months. These did not vary by recurrence detection method (all p > 0.4). Patients whose disease was detected by CA-125 were less likely to undergo SCS than those detected by other means (21.7% vs. 35.0%, p = 0.007). In addition to the 5 patients whose recurrence was detected primarily by pelvic exam, an additional 10 (total n = 15) patients had an abnormal pelvic exam at time of diagnosis of recurrence. Discussion: Recurrence detection method was not associated with differing rates of survival or optimal SCS, however those patients detected by CA-125 were less likely to undergo SCS. The pelvic exam was a useful tool for detecting a significant proportion of recurrences.

Published in Gynecologic Oncology Reports

ISSN: 2352-5789 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Gynecology and obstetrics; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: http://www.journals.elsevier.com/gynecologic-oncology-reports/

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