Patient Surveillance After Ovarian Cancer Treatment Is Variable: Presented at SSO

New data indicate that there is marked variability in the intensity of patient surveillance after curative-intent treatment for ovarian cancer. The results were released here on March 6 at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO).

Garo Harmandayan, DO, St. Louis University School of Medicine, St. Louis, Missouri, and colleagues analysed the responses to a survey completed by members of the Society for Gynecologic Oncologists (SGO).

“While the surveillance of patients after potentially curative treatment of ovarian cancer has important clinical, financial, and legal implications for patients, physicians, and society, the optimal surveillance strategy after initial curative-intent treatment is currently unknown,” Dr. Harmandayan pointed out.

Routine postoperative surveillance testing is practiced by gynaecologists and recommended by many organisations but there is little objective evidence to support any particular surveillance strategy in patients with ovarian cancer, he added.

For their study, the investigators constructed a survey based on 4 idealised vignettes depicting generally healthy women with ovarian cancer of various International Federation of Gynecology and Obstetrics stages.

The SGO members queried in the survey were asked to indicate the number of office visits, pelvic exams, Pap smears, complete blood counts, metabolic panels, serum, Ca-125 levels, chest x-rays, abdominal pelvic computed tomography’s (CTs), chest CTs, abdominal-pelvic magnetic resonance imaging, and transvaginal ultrasound exams they would recommend each year for 10 years after initial curative-intent treatment.

Analysis of 283 evaluable responses showed marked variation in the intensity of surveillance practices.

For example, the number of pelvic exams recommended in the first postoperative year for women with stage 1 ovarian cancer ranged from 1 to 12.

The results also showed that gynaecologist oncologists tended to recommend less testing with increasing postoperative years for all recommended tests. For example, the mean number of times an office visit was recommended for stage IV patients was 4.4 during the first year, which decreased to 1.1 by the tenth year.

The authors said that their study is the first to describe the self-reported practice of experienced clinicians who treat ovarian cancer patients.

Based on their results, they noted that it is now possible to devise well-controlled prospective trials to compare high-intensity versus low-intensity strategies of ovarian cancer patient surveillance strategies.

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