Routine pelvic examination during front-line chemotherapy for ovarian cancer: Should it play a role?

Peter A. Argenta, Rebekah R. Ormsby, Levi S. Downs, Patricia L. Judson, Rahel Ghebre, Linda F. Carson

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine if pelvic examination affected management in patients undergoing first-line chemotherapy for ovarian cancer and to determine a threshold of change in tumor size reliably detectable by pelvic examination. STUDY DESIGN: We reviewed 501 encounters among 47 women with ovarian cancer to see if pelvic examination prompted a management change. Clinicians then evaluated synthetic model "tumors" and were retested at intervals of 3-48 hours to determine change needed for reliable detection. RESULTS: The median number of examinations was 3 during 8 cycles of chemotherapy. Fifteen examinations (10.5%) revealed palpable anomalies, attributable to known tumor in 10 instances. The most common events preceding management change were elevation in serum CA-125 (57%) or chemotherapy toxicity (20%). No changes were made based on pelvic examination alone. When assessing "tumor" volume in a model, estimates ranged from 33-309% of actual volume. Determination of volume change following a delay was poor. No reliable threshold of detection of volume change was established. CONCLUSION: Pelvic examination findings rarely dictated management changes in this study. Further, our resuits call into question the potential of routine pelvic examination to add significantly to clinical management during initial treatment given the wide range of error in "tumor" size estimates.

Original languageEnglish (US)
Pages (from-to)3-7
Number of pages5
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume53
Issue number1
StatePublished - Jan 1 2008

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Gynecological Examination
Ovarian Neoplasms
Drug Therapy
Neoplasms
Tumor Burden
Serum

Keywords

  • Chemotherapy
  • Ovarian cancer
  • Pelvic examination

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Routine pelvic examination during front-line chemotherapy for ovarian cancer : Should it play a role? / Argenta, Peter A.; Ormsby, Rebekah R.; Downs, Levi S.; Judson, Patricia L.; Ghebre, Rahel; Carson, Linda F.

In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist, Vol. 53, No. 1, 01.01.2008, p. 3-7.

Research output: Contribution to journalArticle

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