PHILADELPHIA -- Most women with highly curable early-stage ovarian cancer are not meticulously checked during surgery to see if the disease has spread -- a lapse that could lead to death, according to a new National Cancer Institute study.
The study also found that women frequently are not given the state-of-the-art chemotherapy recommended for ovarian cancer, especially if they are 65 or older and have advanced disease.
"It certainly is disturbing that people aren't getting the treatment we recommend," said Dr. Edward Trimble, an NCI researcher who presented the findings yesterday at the annual meeting of the American Society of Clinical Oncology in Philadelphia.
Ovarian cancer kills about 15,000 women annually in the United States. Nearly 27,000 new cases of the disease are expected to be diagnosed this year.
The cancer has an 85 percent to 90 percent cure rate if it is caught while still confined to the ovaries. But because early symptoms of the disease are vague, three-quarters of all cases are not detected until the cancer is more advanced and far more lethal.
According to NCI guidelines published in 1994, surgeons operating on women with early-stage disease should not simply remove the cancerous ovary.
Even if there are no visible signs of cancer spread, the surgeons should take samples of lymph nodes and other sites around the abdomen and pelvis to check for microscopic signs of disease. If the cancer has spread, chemotherapy is needed.
In the new study, NCI researchers reviewed the cases of 785 women diagnosed with ovarian cancer in 1991. They found that 90 percent of those with early-stage cancer did not get optimal treatment -- most typically their surgeon failed to sample lymph nodes for signs of cancer.
Among women with advanced ovarian cancer, 80 percent received the appropriate surgery and follow-up chemotherapy, the study found. But among those women 65 or older with advanced disease, only 43 percent received state-of-the-art care.
Pub Date: 5/22/96
