[Periodical changes in diagnosis and treatment of ovarian tumors]

Malignant ovarian tumors are one of the most rapidly changing gynecological malignancies concerning diagnosis and treatment during the last 20 years. Clinical cases of about 1,000 malignant ovarian tumors including borderline malignancies enlisted in the Tokai Ovarian Cancer Study Group were analyzed for periodical improvement. A comparison between the 460 cases treated in 1974-1979 and the 574 cases treated in 1980-1985, revealed a nearly 20% improvement in the 5-year survival rate. Also another comparison was made for ovarian carcinoma according to the clinical stage. Periodical improvement was shown in all clinical stages in almost the same amount, which was about 20% or more. The 5-year death rate was compared in accordance with age of patient and histological type of the tumor. Dominant progression was observed in younger generation under forty years of age, and in serous carcinoma and yolk sac tumor. However, no progression was observed for patients in their sixties and unclassified carcinoma. Periodical changes of findings in autopsy were compared between cases autopsied in 1968 and in 1988, according to the annual paper reported by Japan Pathological Society. Number of autopsied cases for malignant ovarian tumors were increased 3 times in 1988. In 1968, nearly 60% of the malignant ovarian tumors were treated by doctors in internal medicine, surgery and radiology etc., rather than gynecology, which was partly because the primary site of the cancer was unknown during the clinical course and partly because the gynecologist gave up treatment of patients in advanced cases.(ABSTRACT TRUNCATED AT 250 WORDS)