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Semin Oncol. 2003 Jun;30(3):401-12.

The follow-up of ovarian cancer.

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Department of Obstetrics and Gynecology, New York University Medical Center, New York, NY 10016, USA.


Few formal guidelines exist regarding the surveillance of patients with epithelial ovarian cancer. The objective of follow-up in patients who have already been treated with primary cytoreductive surgery and first-line chemotherapy is not clear, as recurrent ovarian cancer continues to be a therapeutic dilemma. The vast majority of women with relapses will eventually succumb to their disease. The primary goal of salvage therapy therefore is to maximize disease-free survival and quality of life. Unfortunately, it is not clear whether early detection of recurrent disease is beneficial. Routine physical examinations, testing with serum markers, such as CA-125, radiologic imaging, and second-look surgery have all been employed for the detection of recurrent disease. Evaluation of the efficacy of such post-treatment surveillance methods must look at the sensitivity and specificity of each. Most of the noninvasive techniques have been compared with second-look surgery, which provides the most accurate assessment of disease recurrence available to date. A lack of randomized prospective studies directly evaluating the therapeutic benefits of a second-look procedure restricts its role to research protocols. It is difficult to justify an aggressive approach to follow-up of the asymptomatic patient given the lack of sensitivity of available diagnostic methods and the limitations of current second-line chemotherapy regimens.

[Indexed for MEDLINE]

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