Ovarian cancer recurrence detection may not require in-person physical examination: An MSK team ovary study Journal Article


Authors: Feinberg, J.; Monthie, K. A.; Webster, E.; Chang, K.; McNeil, N.; Chi, D. S.; Long Roche, K.; Gardner, G.; Zivanovic, O.; Sonoda, Y.
Article Title: Ovarian cancer recurrence detection may not require in-person physical examination: An MSK team ovary study
Abstract: OBJECTIVE: Given the inconvenience and financial burden of frequent ovarian cancer surveillance and the risks of in-person visits due to COVID-19, which have led to the acceleration of telehealth adaptation, we sought to assess the role of in-person physical examination for the detection of ovarian cancer recurrence among patients enrolled in a routine surveillance program. METHODS: This was a retrospective study of patients initially seen from January 2015 to December 2017 who experienced ovarian cancer recurrence during first clinical remission. Descriptive statistics and bivariate analyses were performed to compare differences in detection methods and in patient and disease characteristics. RESULTS: Among 147 patients who met our inclusion criteria, there were no recurrences detected by physical examination alone. Forty-six (31%) patients had recurrence first detected by tumor marker, 81 (55%) by radiographic scan, 17 (12%) by presentation of new symptoms, and 3 (2%) by biopsies taken during non-oncological surgery. One hundred and eleven patients (75%) had multiple positive findings at the time of recurrence. Of all 147 patients, 48 (33%) had symptoms, 21 (14%) had physical examination findings, 106 (72%) had increases in tumor markers, and 141 (96%) had changes on imaging. CONCLUSIONS: In-person physical examination was not a primary means of detection for ovarian cancer recurrence for any patient. Substituting in-person visits for virtual visits that include patient-reported symptoms, alongside a regular surveillance protocol that includes tumor marker testing and imaging, may be a suitable approach for the detection of ovarian cancer recurrence while also reducing patient inconvenience and risks to health. © IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords: middle aged; retrospective studies; ovarian cancer; ovarian neoplasms; neoplasm recurrence, local; tomography, x-ray computed; diagnostic imaging; retrospective study; blood; tumor recurrence; ovary tumor; ca 125 antigen; ca-125 antigen; telemedicine; humans; human; female; x-ray computed tomography
Journal Title: International Journal of Gynecological Cancer
Volume: 32
Issue: 2
ISSN: 1048-891X
Publisher: Lippincott Williams & Wilkins  
Date Published: 2022-02-01
Start Page: 159
End Page: 164
Language: English
DOI: 10.1136/ijgc-2021-002885
PUBMED: 34969828
PROVIDER: scopus
PMCID: PMC8825707
DOI/URL:
Notes: Article -- Export Date: 1 March 2022 -- Source: Scopus
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MSK Authors
  1. Ginger J Gardner
    273 Gardner
  2. Dennis S Chi
    713 Chi
  3. Yukio Sonoda
    475 Sonoda
  4. Oliver Zivanovic
    293 Zivanovic
  5. Kaity Chang
    8 Chang
  6. Nita K McNeil
    3 McNeil