Ultrasound in the follow-up of young patients with malignant ovarian tumors after conservative surgery

Ultrasound examinations were performed us a step in the follow-up of 62 patients previously treated with conservative surgery for malignant ovarian tumors. With a minimal follow-up period of 36 months (range 36-129) 12 recurrences of disease were observed in nine patients. When compared to other routine follow-up procedures, ultrasound examination proved to be the most effective procedure in the monitoring of these patients, correctly detecting ten recurrences. Physical and gynecological examinations detected seven, tumor marker measurements detected six and chest X-rays detected one. Ultrasound examination was 83% sensitive, 99% specific and 99% accurate in the detection of recurrent disease. In four recurrences leading to death, the diameters of the tumors at first detection were 25, 50, 50 and 100 mm, significantly higher (p = 0.03) than in seven recurrences followed by complete response of the tumor (range 15-35 mm, median 30 mm). Ultrasound appears to be superior to physical and gynecological examination in early detection of recurrence; considering that smaller burdens of tumor at the time of recurrence seem to imply a better prognosis, ultrasound should be considered us a useful additional procedure in the follow-up of these patients.