Consequences of Frequent Imaging in Recurrent Advanced Ovarian Cancer
Posted: Friday, July 17, 2020
Frequent imaging for women with advanced ovarian cancer can result in earlier detection of recurrence, although it does not seem to improve survival outcomes, according to a study by Roisin E. O’Cearbhaill, MD, and colleagues, of Memorial Sloan Kettering Cancer Center, New York. Their findings were published in the JNCCN–Journal of the National Comprehensive Cancer Network.
This single-center retrospective analysis included a total of 684 patients with stage II to IV high-grade epithelial ovarian cancer in first remission. Of them, 543 underwent frequent CT or MRI imaging of the abdomen/pelvis, and 141 underwent infrequent imaging (> 1 scan per year, and or ≤ 1 scan per year, respectively). Most patients had stage III or IV cancer; all patients had recurrence at least 3 months after completion of first-line platinum-based chemotherapy.
Compared with patients who underwent infrequent imaging, those who underwent frequent imaging had a shorter time to recurrence (19.2 vs. 18.0 months, respectively). This pattern held similar for patients with elevated CA-125 levels at diagnosis. However, no significant difference in overall survival or secondary cytoreductive surgery was observed between the two groups.
“There may be subgroups of patients who clinically benefit from more frequent scanning,” the authors concluded. “Potential disadvantages of surveillance imaging include excess costs, intervention for inconsequential incidental findings, and heightened patient anxiety.”
“We recommend future research using a larger, multi-institutional database to further elucidate the risks versus benefits of surveillance imaging in patients with advanced ovarian cancer and to help guide practice recommendations.”
Disclosure: The study authors’ disclosures can be found at jnccn.org.