Detection of Recurrence in a Surveillance Program for Epithelial Ovarian Cancer

Ovarian cancer patients need a surveillance program for the detection of tumor progression after completionof treatment. The methods generally consist of history taking, physical examination, tumor marker monitoringand imaging. However, the details of recurrence detection with each method are not well defined. To clarify thisissue, ovarian cancer patients who achieved complete or partial responses and developed tumor progressionat the follow up time between January 2004 and December 2010 in University Hospital Chiang Mai, Thailand,were reviewed. Clinical data, CA 125 level and imaging results at the tumor progression time were recorded andanalyzed. There were 144 ovarian cancer patients meeting the inclusion criteria with the mean age of 51 yearsand 62.5% of them were in an advanced stage. Complete response was achieved in 89 patients (61.8%) afterprimary treatment. The median progression free survival and overall survival were 15.5 months and 37.5 months,respectively. Abnormal symptoms presented in 49.3% of the studied patients and 59.7% developed physicalexamination abnormalities. In addition, CA 125 was elevated in 89.6% while in 74.3% of tumor progressionwas identified by CT-scan. Short treatment time period and a high level of CA 125 were significant independentprognostic factors in these patients. In conclusion, careful history taking, physical examination and monitoringof CA 125 levels are important methods for tumor progression detection in a surveillance program for epithelialovarian cancer patients.