Cochrane Collaboration Review:Evaluation of follow-up strategies for patients with epithelial ovarian cancer following completion of primary treatment

Plain language summary

Evaluation of follow-up strategies for patients with epithelial ovarian cancer following completion of primary treatment

Ovarian cancer is the sixth most common cancer and seventh commonest cause of cancer death in women worldwide. Traditionally, many patients who have been treated for cancer undergo long-term follow up in hospitals. Whilst there may be other benefits from follow up, it has been suggested that the use of routine review may not result in women with this disease living longer given that recurrent ovarian cancer is incurable.

We set out to review the evidence for different types of follow up of women who have completed treatment for the commonest type (epithelial, that is coming from the surface of the ovary) of ovarian cancer. Only one good quality  (blogger's note: Rustin trial) randomised (toss of a coin to choose which group) trial was found which could give any evidence on what to do. This trial suggested no increase in length of life from early treatment with chemotherapy for women with recurrence that was identified by a tumour marker (CA125) blood test compared to waiting to give treatment when women developed symptoms from their cancer.

We conclude that the very limited evidence suggests that there may be no benefit from early detection by the blood test and subsequent early chemotherapy for recurrent ovarian cancer. Also, the women having early chemotherapy treatment of their relapsed cancer may have led to a decreased quality of life for these women compared to the group who were treated when they noticed symptoms.

Randomised controlled trials are needed to compare different types of follow up, looking at quality of life and anxiety outcomes. If new treatments become available for relapsed ovarian cancer, the methods of follow up may need re-assessing to see if earlier intervention improves survival or other outcomes.