The Role of Ultrasound Examination in the Selection of Treatment for Ovarian Cancer

Yu.V. Dumansky, K.D. Shkarbun, L.I. Shkarbun

Abstract


Despite the active exploration of ways of optimization the ultrasound examination in the detecting of ovarian cancer screening, questions concerning the possibilities of the method in the evaluation of the prevalence of the process, the relationship of the tumor to adjacent organs and large blood vessels, pelvic adipose tissue and peritoneum still remain unresolved. At the same time, these data are necessary to determine the tactics of optimal treatment for patients with ovarian cancer, first of all to decide on the feasibility of laparotomy and using of neoadjuvant therapy.
We have assessed the possibility of ultrasound examination in the assessment of the prevalence and stage of ovarian cancer to determine the optimal surgical treatment. Taking into account the peculiarities of blood and lymph supply of pelvic organs in women (the presence of anastomosis of lymphatic vessels of the uterus and ovaries with the vessels of the rectum in the recto-vaginal septum), the main objective of the US examination was to identify the tumor infiltration of surrounding organs and tissues, searching the local metastases and involvement of the regional lymph nodes. The original methods of the improving the conventional ultrasound are suggested: transvaginal and transrectal examination with a water-contrast enhancement of the rectum, which effectiveness is evaluated on the material of 19 patients with ovarian cancer.
Selection of women for additional research was conducted on the basis of the following criteria: tumor volume must be greater than 200 cm3, blurring the boundaries between tumor infiltration and surrounding organs, the presence of pelvic ascites. It is noted that the application of own original methods allowed in 7 (36.8 %) cases to supplement the results of conventional research, including in 3 cases (15.8 %) — reveal the involvement of surrounding organs additionally, in 4 cases (21.1 %) — the involvement of the regional lymph nodes, that had an impact on treatment choice of patients as stage II disease transferred to III and neoadjuvant therapy was appointed to these patients. The proposed new original methods of investigation of pelvic cavity made possible to evaluate the effectiveness of treatment in the process of dynamic screening on the basis of standard (conventional) and additional sonographic criteria, which we have developed, including assessment of the condition of the surrounding organs and tissues (rectum, pararectal adipose tissue, loops of cecum and sigmoid colon, rectovaginal area, pelvic peritoneum, iliac vessels). The proposed new original diagnostic ultrasound methods enabled to optimize conventional techniques, improved the quality of the US study of ovarian cancer and can be recommended for widespread use by medical diagnosticians in oncology and gynecology.
It is concluded that the clinical relevance of the developed original methods and the possibility of their wide application in the staging of cancer process and the selection of the optimal surgical treatment.


Keywords


ovarian cancer; surgery; ultrasound diagnostics; the prevalence of the process; staging of cancer

References


Вельшер Л.З., Поляков Б.И., Петерсон С.Б. Клиническая онкология. — М.: ГЭОТАР-Медиа, 2009. — С. 387-403.

Лучевая диагностика злокачественных опухолей яичников / Терновой С.К., Насникова И.Ю., Морозов С.П. [и др. ] // Вестник рентгенологии и радиологии. — 2009. — № 4–6. — С. 47-57.

Михановский А.А. Оценка эффективности неоадъювантной химиотерапии у больных раком яичников / А.А. Михановский, А.В. Прокопюк, Т.Д. Павлова // Матеріали XI з’їзду онкологів України, 29 травня — 02 червня 2006 р., Судак, Крим. — Київ, 2006. — С. 188-189.

Пат. 74079 Україна, МПК А61В8/08. Спосіб діагностики новоутворень яєчників / Шкарбун К.Д., Шкарбун Л.І.; заявник та патентовласник Донецький національний медичний університет ім. М. Горького. ― № u 201206371; заявл. 28.05.2012; опубл. 10.10.2012, бюл. № 19.

Показники здоров’я населення та діяльності медичних установ Донецької області (включно з ЛПЗ безпосередньо підпорядкованих МОЗ) за 2011 рік: статистичні матеріали. — Донецьк, 2011. — 270 с.

Прокопюк О.В. Клiнiко-бiохiмiчнi та ультразвуковi критерiї оцінки ефективностi неoад’ювантної полiхiмiотерапiї у хворих на рак яєчників III–IV стадiй: автореф. дис. на здоб. наук. ступ. канд. мед. наук. — К., 2010. — 24 с.

Синицина М.Е. Роль ультразвуковой томографии в предоперационном стадировании и оценке эффективности лечения рака яичников : Дисс. на соиск. ученой степени канд. мед. наук / М.Е. Синицина. — М., 2007. — 140 с.

Guidelines and Selection Criteria for Secondary Cytoreductive Surgery in Patients with Recurrent, Platinum-Sensitive Epithelial Ovarian Carcinoma / Chi D.S., McCaughty K., Diaz John P. [et al] // CANCER. — 2006. — Vol. 106, № 9. — Р. 1933-1939.

Lutz A.M., Willmann K.J., Drescher Ch.W. Early Diagnosis of Ovarian Carcinoma: Is a Solution in Sight? // Radiology. — 2011. — Vol. 259, №. 2. — P. 329-345.




DOI: https://doi.org/10.22141/1997-2938.2.21.2013.87447

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