Chest CT isn't necessary for routine follow-up of ovarian cancer patients, according to a recent study in the American Journal of Roentgenology.
Researchers from the Hadassah University Hospital in Jerusalem, Israel retrospectively reviewed the radiological follow-up of 127 women with metastatic ovarian cancer who had received surgery and chemotherapy between 1985 and 1996 (AJR, October 2001, Vol. 177:4, pp. 857-859).
Of the 127 women with stage III or stage IV cancer, 82 (65%) had at least one chest CT scan, with more than 50% having three or more studies. Thirty-two patients (39%) had radiologic evidence of disease, while 28 (34%) showed disease in the abdomen and pelvis but not in the chest, according to the researchers.
Eighteen patients (22%) had both chest and abdominal or pelvic CT scans that indicated disease. In all of these patients, however, abdominal or pelvic disease had appeared on scans before spreading to the chest, the researchers noted.
Four (5%) of the patients had isolated chest disease; lung metastases from ovarian carcinoma occurred in 6% of the patients. In all of the patients, pulmonary metastases were preceded either by abdominal or pelvic disease or by a rise in tumor markers, according to the study team.
"The most common thoracic involvement in patients who have been treated for ovarian carcinoma is pleural effusion, which can easily be revealed on abdominal CT images performed according to standard protocols," the authors concluded.
Pulmonary metastases are rare, and usually are preceded by recurrence of disease in the abdomen or pelvis, the authors wrote. "Therefore, we suggest that chest CT scanning may be eliminated from the routine follow-up protocol of patients who have had ovarian carcinoma, and ... reserved for those patients with elevated serum tumor markers but without evidence of abdominal or pelvic disease."
By Erik L. RidleyAuntMinnie.com staff writer
November 16, 2001
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