Department of Molecular, Cell and Developmental Biology, UCLA College of Letters and Science, Los Angeles, CA, USA.
Br J Cancer. 2010 Nov 23;103(11):1657-62. doi: 10.1038/sj.bjc.6605963. Epub 2010 Nov 2.
The purpose of this study was to evaluate the number of ovarian cancer and primary peritoneal cancer (PPC) progressive disease cases identified via routine follow-up procedures and the corresponding cost throughout a 16-year period at a single medical institution.
Previously undiagnosed epithelial ovarian (n=241), PPC (n=23), and concurrent ovarian and uterine (n=24) cancer patients were treated and then followed via CA-125, imaging (e.g., CT scan, chest X-ray), physical examination and vaginal cytology.
In the group of 287 patients, there were 151 cases of disease progression. Serial imaging detected the highest number of progressive disease cases (66 initial and 45 confirmatory diagnoses), but the cost was rather high ($13,454 per patient recurrence), whereas CA-125 testing (74 initial and 20 corroborative diagnoses) was the least expensive ($3,924) per recurrent diagnosis. The total cost of surveillance during the 16-year period was nearly $2,400,000.
Ultimately, serial imaging and the CA-125 assay detected the highest number of ovarian cancer and PCC progressive disease cases in comparison to physical examination and vaginal cytology, but nevertheless, all of the procedures were conducted at a considerable financial expense.
本研究旨在评估在一家医疗机构的 16 年期间，通过常规随访程序识别的卵巢癌和原发性腹膜癌（PPC）进展病例的数量及其相应的成本。
对先前未经诊断的上皮性卵巢癌（n=241）、原发性腹膜癌（n=23）和同时性卵巢和子宫癌（n=24）患者进行治疗，然后通过 CA-125、影像学（如 CT 扫描、胸部 X 光检查）、体格检查和阴道细胞学进行随访。
在 287 名患者中，有 151 例疾病进展。连续影像学检测到最多的进展性疾病病例（66 例初始诊断和 45 例确诊诊断），但成本相当高（每位患者复发的成本为 13454 美元），而 CA-125 检测（74 例初始诊断和 20 例证实性诊断）的复发诊断费用最低（每位患者复发的成本为 3924 美元）。在 16 年的监测期间，总监测费用接近 240 万美元。
最终，与体格检查和阴道细胞学检查相比，连续影像学和 CA-125 检测检测到了最高数量的卵巢癌和 PPC 进展性疾病病例，但所有这些程序的进行都需要大量的财务支出。
