Surveillance for the detection of recurrent ovarian cancer: Survival impact or lead-time bias?

Edward J. Tanner, Dennis S. Chi, Eric L. Eisenhauer, Teresa P. Diaz-Montes, Antonio Santillan, Robert E. Bristow*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

64 Scopus citations


Objective: To compare the survival impact of diagnosing recurrent disease by routine surveillance testing versus clinical symptomatology in patients with recurrent epithelial ovarian cancer (EOC) who have achieved a complete response following primary therapy. Methods: We identified all patients who underwent primary surgery for EOC at two institutions between 1/1997 and 12/2004 and were diagnosed with recurrent disease following a complete clinical response to primary chemotherapy. Survival and post-recurrence management were compared between asymptomatic patients in which recurrent disease was diagnosed at a scheduled visit by routine surveillance testing and symptomatic patients in which recurrent disease was diagnosed based on clinical symptomatology at an unscheduled office visit or hospitalization. Results: Of the 121 patients that met inclusion criteria, 22 (18.2%) were diagnosed with a symptomatic recurrence. Median primary PFS was similar for asymptomatic and symptomatic patients (24.8 versus 22.6 months, P = 0.36); however, post-recurrence survival was significantly greater in asymptomatic patients (45.0 versus 29.4 months, P = 0.006). Secondary cytoreductive surgery (SCRS) was attempted equally in both groups (41% versus 32%, P = NS); however, optimal residual disease (≤5mm) was more often achieved in asymptomatic patients (90% versus 57%, P = 0.053). On multivariate analysis, detection of asymptomatic recurrence was a significant and independent predictor of improved overall survival (P = 0.001). Median OS was significantly greater for asymptomatic patients (71.9 versus 50.7 months, P = 0.004). Conclusions: In patients with platinum-sensitive EOC, detection of asymptomatic recurrences by routine surveillance testing was associated with a high likelihood of optimal SCRS in operative candidates and extended overall survival.

Original languageEnglish (US)
Pages (from-to)336-340
Number of pages5
JournalGynecologic oncology
Issue number2
StatePublished - May 1 2010


  • Follow-up
  • Ovarian cancer
  • Recurrence
  • Surveillance

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology


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