Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA
Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.
Int J Gynecol Cancer. 2022 Jul 4;32(7):913-917. doi: 10.1136/ijgc-2022-003506.
Given the recent rapid increase in telemedicine in the setting of the COVID-19 pandemic, we sought to investigate the utility of symptom review, CA125, and physical examination in the detection of ovarian cancer recurrence to determine the role of virtual surveillance care in the COVID-19 era.
This retrospective cohort study included patients diagnosed with ovarian cancer between 2013 and 2020 who achieved remission after primary treatment and then had recurrence while in a routine surveillance program. Modalities that detected recurrence including symptoms, CA125, physical examination, or 'other,' which was denoted if imaging was obtained for reasons other than suspected recurrence and recurrence was incidentally identified, were recorded. Descriptive statistics were performed to summarize the cohort.
One hundred and nine patients met inclusion criteria. At time of recurrence, elevated CA125 was present in 97 (89.0%) patients, symptoms in 41 (37.6%), and abnormal physical exam findings in 27 (24.8%). Recurrence was incidentally found with imaging obtained for reasons other than suspicion of recurrence in six (5.5%) patients. Recurrence was suspected based on multiple modalities in 46 (42.2%) patients. Elevated CA125, symptoms, or both were present in 102 (93.6%) patients. Of patients with abnormal physical exam findings, 26 (96.3%) also had elevated CA125 or symptoms present. Recurrence was suspected based on physical exam findings alone in one (0.9%) patient.
Over 90% of ovarian cancer recurrences were detected by rising CA125, symptoms, or both. Only one patient had recurrence detected by physical examination alone. Given that review of symptoms and CA125 can be conducted virtually, virtual visits may offer a reasonable alternative to in-person visits for ovarian cancer surveillance for patients who have pre-treatment elevated CA125.
鉴于 COVID-19 大流行期间远程医疗的迅速发展，我们旨在研究症状评估、CA125 和体格检查在卵巢癌复发检测中的作用，以确定虚拟监测护理在 COVID-19 时代的作用。
本回顾性队列研究纳入了 2013 年至 2020 年间确诊为卵巢癌并在初次治疗后缓解，然后在常规监测计划中复发的患者。记录检测复发的方式，包括症状、CA125、体格检查或“其他”（表示如果因疑似复发以外的原因获得影像学检查，且意外发现复发）。采用描述性统计方法总结队列。
109 例患者符合纳入标准。在复发时，97 例（89.0%）患者的 CA125 升高，41 例（37.6%）有症状，27 例（24.8%）有异常体格检查结果。6 例（5.5%）患者因疑似复发以外的原因获得影像学检查，意外发现复发。46 例（42.2%）患者基于多种方式怀疑复发。102 例（93.6%）患者存在升高的 CA125、症状或两者兼有。26 例（96.3%）有异常体格检查结果的患者同时存在 CA125 升高或有症状。1 例（0.9%）患者仅根据体格检查结果怀疑复发。
超过 90%的卵巢癌复发是通过 CA125 升高、症状或两者兼有的方式检测到的。只有 1 例患者仅通过体格检查发现复发。鉴于症状和 CA125 的评估可以通过虚拟方式进行，对于治疗前 CA125 升高的患者，虚拟就诊可能是卵巢癌监测的一种合理替代方案。
