Current and Emerging Strategies for Tubo-Ovarian Cancer Diagnostics

Abstract

Tubo-ovarian cancer is the most lethal gynaecological cancer. More than 75% of patients are diagnosed at an advanced stage, which is associated with poorer overall survival. Symptoms at presentation are vague and non-specific, contributing to late diagnosis. Multimodal risk models have improved the diagnostic accuracy of adnexal mass assessment based on patient risk factors, coupled with findings on imaging and serum-based biomarker tests. Newly developed ultrasonographic assessment algorithms have standardised documentation and enable stratification of care between local hospitals and cancer centres. So far, no screening test has proven to reduce ovarian cancer mortality in the general population. This review is an update on the evidence behind ovarian cancer diagnostic strategies.

Keywords: biomarkers; diagnosis; imaging; ovarian cancer; screening.

Figure 1

Ovarian cancer: recognition and initial management. Adapted from NICE Clinical guideline [5].

Figure 2

Serum biomarker profile associated with specific germ cell tumour histological subtypes adapted from Benoit et al. [41].

Figure 3

IOTA simple rules comprising B (benign) and M (malignant) features [67].

Figure 4

Benign simple descriptors for the identification of benign ovarian cystic lesions.

Figure 5

The O-RADS MRI categories and their respective interpretation.