What are the means of checking for recurrence of ovarian cancer

If ovarian cancer achieves complete remission after initial treatment and lesions are found again 6 months after stopping chemotherapy, it is called recurrent ovarian cancer. Recurrence can occur at any time after the initial treatment remission, and clinically 2 to 3 years is the most common.

For patients with recurrent ovarian cancer who have already developed symptoms, a gynecological triple examination can often reveal recurrent lesions in the pelvis, especially those occurring above the vaginal stump; serum CA125 and other tumor markers may progressively increase; and imaging examinations can often reveal recurrent lesions in the liver, spleen, kidney, adrenal gland, lung, mediastinum, peritoneum, lymph nodes, and other locations.

It is worth noting that some patients will not have any symptoms or imaging changes in the early stage of relapse, but serum markers have increased. For these patients, markers should be checked once a month. If they increase exponentially for three consecutive times, relapse can be considered and appropriate imaging methods can be selected to further clarify the diagnosis. Using imaging examinations too early may not only be unhelpful in detecting recurrent lesions, but also increase the financial and mental burden on patients.

In the imaging examination of ovarian cancer, B-ultrasound, especially color B-ultrasound, is the first choice, because the vast majority of ovarian cancer recurrence lesions are still located in the pelvis and abdominal cavity, and the examination is non-invasive and inexpensive. If necessary, other appropriate imaging methods can be selected based on the estimated location of the most likely recurrence lesions. For example, CT is sensitive to lesions occurring in the liver, spleen, peritoneum, lungs, etc.; MRI is more sensitive than CT in diagnosing recurrence of pelvic soft tissues; ECT and PET/CT have unparalleled advantages in determining the number and location of recurrence lesions due to their dual effects of combining anatomical imaging and functional imaging. In particular, the diagnostic rate and positive predictive value of PET/CT can reach more than 90%, making it the most accurate localization diagnosis method currently.