Effect of Tumor Stage on Surveillance Strategies after Treatment for Ovarian Cancer

Background: Given that ovarian cancer has a generally poor prognosis and tends to recur with low survival rates, surveillance of these cancers after treatment is vital. However surveillance strategies tend to vary among gynecologic oncologists. Objective: This survey was conducted to evaluate if initial International Federation of Gynecology and Obstetrics stage accounts for the variation in surveillance strategies used by gynecologic oncologists after initial curative-intent treatment for ovarian carcinoma. Materials and Methods: We created a survey instrument directed to the Society of Gynecologic Oncology (SGO). The survey was conducted by e-mail and included SGO members and candidate members. The 943 SGO members were asked to report how frequently they recommended 11 surveillance modalities in years 1-5 and 10 after primary treatment. Statistical evaluation included generalized linear models with a Poisson distribution. Results: Two hundred and eighty-three of the survey results were evaluable. For several surveillance modalities (office visit, pelvic examination, complete blood count, serum CA-125 level, and comprehensive metabolic panel), the frequency of recommended use was statistically significantly greater for more advanced stage tumors. Conclusions: The intensity of surveillance recommended by practicing gynecologic oncologists varies significantly based on initial patient stage and perceived prognosis. However, the variability related to initial prognosis is clinically small and cannot account for the overall variability previously reported.