Chan K K L, Tam K F, Tse K Y, Ngan H Y S
Department of Obstetrics and Gynaecology, University of Hong Kong, Queen Mary Hospital, 102, Pokfulam Road, Hong Kong, China.
Gynecol Oncol. 2008 Aug;110(2):158-61. doi: 10.1016/j.ygyno.2008.04.030. Epub 2008 Jun 9.
To evaluate how ovarian recurrences were first detected and the relative role of Ca 125, symptom enquiry and physical examination in recurrence detection.
In this retrospective study, records from women with ovarian cancer recurrences diagnosed between 1999 and 2004 were reviewed to determine how the recurrences were first detected. Women were routinely followed up by a combination of symptom enquiry, physical examination and Ca 125. When recurrence was suspected, further investigations such as imaging and biopsy of the suspected recurrence would be arranged to confirm the diagnosis. The patients were followed up for a median of 53.5 months.
Eighty patients were identified to have ovarian cancer recurrences, with median time to recurrence of 12 months. Although 41 (51%) had abnormal physical findings, only three (3.8%) first presented with physical findings and none had positive physical findings alone. Ca 125 taken at the clinic visits in these 3 patients when the signs were detected turned out to be raised. For the remaining 77 patients, 49 (61%) and 28 (35%) first presented with raised Ca 125 level and symptoms respectively. The median survival from the time of recurrence for those first presented with Ca 125, symptoms and physical findings were 25 months, 17 months and 11 months respectively.
Routine physical examination had a very limited additional role and could be possibly omitted as part of the routine follow up strategy.
评估卵巢癌复发是如何首次被检测到的，以及癌抗原125（Ca 125）、症状询问和体格检查在复发检测中的相对作用。
在这项回顾性研究中，对1999年至2004年间被诊断为卵巢癌复发的女性患者的记录进行了回顾，以确定复发是如何首次被检测到的。对女性患者进行常规随访，采用症状询问、体格检查和Ca 125检测相结合的方法。当怀疑复发时，会安排进一步的检查，如对疑似复发部位进行影像学检查和活检，以确诊。患者的中位随访时间为53.5个月。
确定有80例患者出现卵巢癌复发，复发的中位时间为12个月。虽然41例（51%）有异常体格检查结果，但只有3例（3.8%）最初表现为体格检查异常，且无一例单独出现阳性体格检查结果。在这3例出现体征时在门诊进行的Ca 125检测结果显示升高。对于其余77例患者，分别有49例（61%）和28例（35%）最初表现为Ca 125水平升高和出现症状。首次出现Ca 125升高、症状和体格检查异常的患者从复发时起的中位生存期分别为25个月、17个月和11个月。
常规体格检查的额外作用非常有限，作为常规随访策略的一部分可能可以省略。
