Pregledni rad
FOLLOW-UP OF EPITHELIAL OVARIAN CANCER PATIENT AFTER PRIMARY TREATMENT (Controversies and actual guidelines)
Dragan Belci
; Djelatnost za ginekologiju i porodništvo, Opća bolnica Pula
Herman Haller
; Klinika za ginekologiju i porodništvo, KBC Rijeka
Nicoletta Colombo
; Europski Onkološki Istitut, Milano
Angelo Maggioni
; Europski Onkološki Istitut, Milano
Sažetak
All the guidelines published regarding the follow up of patient primary treated for ovarian cancer and other gynecological cancer, are the results only of few studies not randomised and in absence of evidence of effectiveness and cost/benefit of the procedure used for diagnosis of recurrent disease.
Few formal guidelines exist regarding the surveillance of these patients, and there is no agreement in the literature about the type and timing of examinations to perform. Moreover, the objective of follow-up is unclear as recurrent epithelial ovarian cancer continues to be a therapeutic dilemma and quite all the relapsed patients will eventually die of their ¬disease. The follow-up of asymptomatic patients generally include complete clinical history, serum cancer antigen (CA 125) assay, physical examination, and often ultrasound examination, whereas additional radiologic imaging techniques are usually performed when symptoms or signs appear.
Currently, there exist two opposite tendencies suggesting different follow-up modalities. On one side »minimalistic« follow-up and on the other side, the introduction of new drugs and new technologies induce the physician to prescribe expensive examinations without proved utility. Prospective randomised clinical trials have to be planned in order to ¬compare minimalistic and intensive follow-up policies. These trials have to evaluate the relationship between the gynecological oncologist’s needs (good quality scentific data available, which leads the best clinical practice), patient’s need (according to the satisfaction degree they feel about the treatments and follow-up) and possibility of health care system. New clinical trials also are needed in order to evaluate the relationship between the objective clinical outcome (overall survival, disease-free interval, and complications) and the subjective outcome (quality of life and expentacies of the patient).
Ključne riječi
ovarian cancer; follow-up; guidelines
Hrčak ID:
62192
URI
Datum izdavanja:
1.9.2008.
Posjeta: 1.927 *