Objective
Patient
surveillance after potentially curative treatment of ovarian carcinoma
has important clinical and financial implications for patients and
society. The optimal intensity of surveillance for these patients is
unknown. We aimed to document the current follow-up practice patterns of
gynecologic oncologists.
Methods
We
created four idealized vignettes describing patients with stages I–III
ovarian cancer. We mailed a custom-designed survey instrument based on
the vignettes to the members of the Society of Gynecologic Oncologists
(SGO). SGO members were asked, via this instrument, how often they
requested 11 discrete follow-up evaluations for their patients for the
first 10 postoperative years after treatment with curative intent.
Results
We
received 283 evaluable responses (
30%) from the 943 SGO members and
candidate members. The most frequently performed items for each year
were office visit, pelvic examination, and serum CA-125 level. Imaging
studies such as chest X-ray, abdominal–pelvic CT, chest CT,
abdominal–pelvic MRI, and transvaginal ultrasound were rarely
recommended. There was marked variation in the frequency of use of most
tests. There was a decrease in the frequency of testing over time for
all modalities.
Conclusion
This
dataset provides detailed documentation of the self-reported
surveillance practices of highly credentialed experts who manage
patients with ovarian cancer in the 21st century.
The optimal follow-up
strategy remains unknown and controversial. Our survey showed marked
variation in surveillance intensity. Identifying the sources of this
variation warrants further research.
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