Ovarian carcinoma follow-up: US versus laparotomy.

Khan, Omar; Cosgrove, David O.; Fried, A M; Savage, P. E. A.

doi:10.1148/radiology.159.1.3513245

Cited by 17 publications

(3 citation statements)

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“…Ultrasound (USS) has been shown to be more sensitive than clinical examination alone in detecting recurrence (Khan 1986) and has an overall accuracy of 98% when compared to findings at laparotomy. In women with no clinical or biochemical signs of relapse, USS has been shown to have a positive predictive value of 100% with only one false negative out of 275 cases (Testa 2005).…”

Section: Discussionmentioning

confidence: 99%

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

Kew

Galaal²,

Bryant

et al. 2011

Cochrane Database of Systematic Reviews

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Background Ovarian cancer is the sixth most common cancer and seventh cause of cancer death in women worldwide. Traditionally, many patients who have been treated for cancer undergo long-term follow up in secondary care. Recently however it has been suggested that the use of routine review may not be effective in improving survival, quality of life (QoL), and relieving anxiety. In addition, it may not be cost effective. Objectives To compare the potential benefits of different strategies of follow up in women with epithelial ovarian cancer following completion of primary treatment. Search methods We searched the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2010, Issue 4), MEDLINE and EMBASE (to November 2010). We also searched CINAHL, PsycLIT, registers of clinical trials, abstracts of scientific meetings, reference lists of review articles, and contacted experts in the field. Selection criteria All relevant randomised controlled trials (RCTs) that evaluated follow-up strategies for patients with epithelial ovarian cancer following completion of primary treatment. Data collection and analysis Two review authors independently abstracted data and assessed risk of bias. Main results We found only one RCT (Rustin 2010) that met our inclusion criteria. This trial included 529 women and reported data on immediate treatment versus delayed treatment in women with confirmation of remission and with normal CA125 concentration and no radiological evidence of disease after surgery and first-line chemotherapy. Overall survival showed no significant difference between the immediate and delayed arms after a median follow up of 56.9 months (unadjusted hazard ratio (HR) = 0·98, 95% confidence interval (CI) 0·80 to 1·20; P = 0·85). Time from randomisation to first deterioration in global health score or death was significantly shorter in the early group compared with the delayed group (HR 0·71, 95% CI 0·58 to 0·88; P < 0·01). The trial was at low risk of bias. Authors’ conclusions There is a lack of randomised studies on most aspects of follow-up care after treatment for epithelial ovarian cancers. Limited evidence from a single trial suggests that routine surveillance with CA125 in asymptomatic patients, with treatment at CA125 relapse, does not seem to offer survival advantage when compared to treatment at symptomatic relapse. Randomised controlled trials are needed to compare different types of follow up on the outcomes of survival, quality of Life, cost and psychological effects.

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Section: Discussionmentioning

confidence: 99%

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

Kew

Galaal²,

Bryant

et al. 2011

Cochrane Database of Systematic Reviews

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“…Pontalis is most interested in returning to Freud's 'selfanalysis' as the primary relationship whose description is an attempt to understand the strange confrontation that the analytic setting constitutes: 'It is only with Freud that self-experience finds its true instrumentality through the other for reflective introspection and discovery.' 17 It is not surprising that he would come to this point, given the recent tendency of writers, intellectuals and academics from the high theoretical ground in France to embrace the first-person account, to privilege the subjective, intimate voice over the voice of public authority, literary or scientific.…”

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confidence: 99%

Psychoanalysis is on the Couch: France Celebrates Freud in 2000

Quinney

2004

French Cultural Studies

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This article assesses the public response in France in 2000 to the centenary celebration of the publication of Freud’s The Interpretation of Dreams. It argues that the discussions that took place during this event provoked a re-evalution of the status of psychoanalysis in France today. Rather than unsettling psychoanalysis as a cultural institution in France, however, the large volume of commentary produced revealed a general faith in psychoanalysis’s unwavering stability and vitality in the public imagination. Through an analysis of these discussions, this article underscores the ways in which the French public reaction to the celebration serves as an important metric for gauging the cultural stakes at issue when interrogating the future of psychoanalysis in France. Finally, the recent work of J.-B. Pontalis provides one example of a contemporary approach embraced by practising French psychoanalysts to respond to the major vectors of criticism about the profession from other branches of psychology and psychiatry.

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“…When patients are assessed non-surgically the two major imaging techniques used are computerised axial tomography (CT) and ultrasonography (US). US is effective in assessing disease in the pelvis, upper abdomen and liver and is a very sensitive method of diagnosing the presence of ascites but it is not a good method of diagnosing disease in the omentum, mesentery or bowel (Khan et al, 1986). CT is probably more accurate in diagnosing the presence of disease in certain areas such as paraaortic lymph nodes (Kerr-Wilson et al, 1984;Wicks et al, 1984;Sonnendecker & Butterworth, 1985;Sommer et al, 1982), the omentum, mesentery and sub-diaphragmatic regions (Sommer et al, 1982;Levitt et al, 1978;Bernardino et al, 1979;Whitley et al, 1981;Johnson et al, 1983).…”

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confidence: 99%

The impact of computed tomography and ultrasonography on the management of patients with carcinoma of the ovary

Gore

Cooke²,

Wiltshaw³

et al. 1989

Br J Cancer

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Summary We have carried out a prospective study on the impact of computed tomography (CT) and ultrasonography (US) on the management of patients with carcinoma of the ovary. Seventy-eight CT and 88 US scans were performed on 94 patients. Clinicians decided patient management prospectively at the time the CT and/or US was ordered. Clinical assessment differed from the result obtained by CT or US in 45% of cases (35/78 and 40/88, respectively). CT and US altered patient management in only a minority of cases (14/78, 18% and 9/88, 10% respectively). Even when the scan and clinical assessments differed, management was only altered on 14/35 (40%) occasions after CT and on 9/40 (23%) occasions after US, a difference which was not significant. In patients with clinically undetectable disease, management was altered by CT on 17% of occasions and by US on 10%. We conclude that in patients with carcinoma of the ovary CT and US alters patient management in a minority of cases. In view of current financial restrictions in health care, clinicians should be more selective in the use of these imaging techniques. Furthermore, we recommend that similar prospective studies are performed for other clinical situations.Clinical and radiological assessment of patients with car-

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Ovarian carcinoma follow-up: US versus laparotomy.

Cited by 17 publications

References 0 publications

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

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

Psychoanalysis is on the Couch: France Celebrates Freud in 2000

The impact of computed tomography and ultrasonography on the management of patients with carcinoma of the ovary

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