Ultrasound examination in ovarian cancer patients. A comparison with second look laparotomy

A series of 129 patients with International Federation of Gynecology and Obstetrics (FIGO) stage III-IV ovarian cancer, were evaluated with ultrasound examination and second look surgery. Results of both modalities were correlated in order to assess the reliability of ultrasound in detecting residual disease. After six cycles of chemotherapy, ultrasound was negative in 94 patients and positive in 35 patients. At second look, 57 patients were in complete pathologic remission, 16 had microscopic residual disease, 23 had macroscopic disease less than 2 cm, and 33 had macroscopic disease greater than 2 cm. Correlating ultrasonography and laparotomy, high correlations were seen in patients with no residual disease (92.2%); on the other hand, ultrasound examinations exhibited poor sensitivity and specificity in patients with microscopic disease (6.2%) and residual disease less than 2 cm (8.6%). Using ultrasound discrimination among patients with no residual disease, microscopic disease, or macroscopic disease less than 2 cm does not appear possible. Our suggestion is that ultrasound is not able to replace second look laparotomy in the detection of minimal residual disease in ovarian cancer patients.