Surveillance Visits for Ovarian Cancer: Is It Time to Reconsider?

Background and objectives: The objective of this study was to examine patterns of recurrence and presentation of ovarian cancer (OC) patients.

Methods: This was a retrospective review of all patients at a single academic institution diagnosed with OC between January 1, 2014, and December 31, 2022. Demographic and clinical characteristics were extracted. Cox proportional hazards models were utilized to compare these characteristics, while the Kaplan-Meier method was employed to determine overall survival (OS).

Results: During our study, 437 patients were diagnosed with OC, and 173 (39.6%) were diagnosed with recurrence. For those diagnosed with recurrence, 68 (39.3%) were symptomatic. Forty-eight (72.7%) symptomatic patients had abdominal pain or increased abdominal girth, 5 (7.6%) had shortness of breath, 1 (1.5%) had vaginal bleeding, and 12 (18.1%) had nonspecific symptoms. Among the 105 (60.7%) asymptomatic patients, 57 (54.3%) had increasing CA-125 levels. Four (2.32%) patients with recurrence were diagnosed on a routine pelvic exam, and only one (0.5%) patient was asymptomatic and incidentally diagnosed.

Conclusions: The majority of patients were asymptomatic at the time of diagnosis, and the pelvic exam was not the primary means of detecting OC recurrence. Guidelines for surveillance visits for OC patients and the utility of a pelvic exam should be examined.