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. 2010 Nov 23;103(11):1657-62.
doi: 10.1038/sj.bjc.6605963. Epub 2010 Nov 2.

The utility and cost of routine follow-up procedures in the surveillance of ovarian and primary peritoneal carcinoma: a 16-year institutional review

N B Rettenmaier  1 , C R Rettenmaier, T Wojciechowski, L N Abaid, J V Brown 3rd, J P Micha, B H Goldstein
Affiliations

The utility and cost of routine follow-up procedures in the surveillance of ovarian and primary peritoneal carcinoma: a 16-year institutional review

N B Rettenmaier et al. Br J Cancer. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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Figures

Figure 1
Figure 1
Distribution of confirmatory abnormal studies in the surveillance of ovary cancer.
Figure 2
Figure 2
Progression-free survival according to cancer site.
See this image and copyright information in PMC

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