Evaluation of preoperative investigations in patients admitted for ovarian primary cytoreductive surgery

Consistent with universally established practice, it has been customary in our unit to subject patients with clinically suspected or biopsy proven ovarian cancer to a large number of preoperative investigations. This is in order to determine metastases, surgical strategy, and exclusion of pelvic kidney. This study presents a comparison of the preoperative ultrasonography, computerized tomography, intravenous pyelography, chest X-ray, liver and bone scintigraphy, and barium enema results performed in 100 cases with the operative findings. These investigations were found to have marginal value in determining extent of disease, upper gastrointestinal metastatic deposits, and the need for or extent of bowel resection. It is concluded that such a standard workup, which is time-consuming and distressing for an already anxious patient, is not cost effective for a surgical procedure which is ultimately determined at laparotomy.