[Computed tomography and tumor markers as diagnostic alternatives to second-look surgery in the treatment of malignant ovarian tumors]

Radiol Med. 1992 Apr;83(4):374-82.
[Article in Italian]

Abstract

Advanced malignant ovarian cancers are treated, after initial surgery, with first-choice mono/polychemotherapy, the response to which is evaluated by means of second-look laparotomy. The poor prognostic value of second-look results, the incidence of false negatives, the lack of valuable second-choice therapies, and the high incidence of complications after repeated interventions, lead to the testing of diagnostic imaging modalities--especially CT and tumor markers (Ca 125 and Ca 15-3). To define their actual clinical value, CT and serum assays of Ca 125 and Ca 15-3 have been performed on 32 treated patients affected with ovarian cancers (stages II-IV), who were clinically free of disease. The results have been compared with second-look pathology, but especially with patient follow-up (min. 24 months). Second-look laparotomy yielded a high number of false negatives (9/22 = 41%); moreover, many important/severe complications were observed. Thus, its value appears to be questionable. CT exhibited high positive predictive value (76.9% over the 24-month follow-up); high for both Ca 125 and Ca 15-3 (100% respectively, at 24-month follow-up) thus, few false positives were observed. Moreover CT, having higher sensitivity (55.5%) than Ca 125 (11.5%) and Ca 15-3 (27.7%), has greater diagnostic capabilities, especially when the lesion is in extraperitoneal location.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Aged
  • Antigens, Tumor-Associated, Carbohydrate / blood
  • Biomarkers, Tumor / blood*
  • Combined Modality Therapy
  • False Negative Reactions
  • False Positive Reactions
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / therapy
  • Remission Induction
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Tomography, X-Ray Computed* / statistics & numerical data

Substances

  • Antigens, Tumor-Associated, Carbohydrate
  • Biomarkers, Tumor