This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nouriani, M. Articles by Dubeau, L. Search for Related Content PubMed PubMed Citation Articles by Nouriani, M. Articles by Dubeau, L.

Detection of Residual Subclinical Ovarian Carcinoma after Completion of Adjuvant Chemotherapy

¹ Division of Gynecologic Oncology and Departments of ² Pathology and ³ Preventative Medicine, University of Southern California Keck School of Medicine, Los Angeles, California; ⁴ Division of Gynecologic Oncology, University of California, Los Angeles School of Medicine, Los Angeles, California; ⁵ Division of Gynecologic Oncology, Tulane Medical School, New Orleans, Louisiana; ⁶ Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; ⁷ Section of Gynecologic Surgery, Mayo Clinic, Rochester, Minnesota; ⁸ New York University School of Medicine, New York, New York; ⁹ Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah; ¹⁰ Gynecologic Oncology Associates, La Jolla, California; ¹¹ Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas; and ¹² Divisions of Hematology-Oncology and Gynecologic Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

Purpose: We sought to test the hypothesis that the presence of telomerase activity in peritoneal washings of patients treated for ovarian carcinoma is a sensitive and specific indicator of the presence of residual disease. We hypothesized that this test, if added to second-look procedure protocols, could help determine whether residual disease is present or not in patients who have completed their adjuvant chemotherapy for ovarian carcinoma.

Experimental Design: Peritoneal washings were obtained from 100 consecutive patients undergoing a second-look procedure after treatment for ovarian carcinoma (cases) and from 100 patients undergoing surgery for benign gynecological conditions (controls). The washings were assayed for telomerase activity using the telomerase repeat amplification protocol. The results were compared to the histological and cytological findings.

Results: Among our 100 cases, 82 (82%) had either positive second-look procedures or expressed telomerase in their peritoneal washings. Fifty-three (53%) had positive second-look procedures, whereas 66 (66%) tested positive for telomerase. Twenty-nine of the 47 patients (62%) with negative second-look procedures tested positive for telomerase. Of the 53 patients with positive second-look procedures, 37 (70%) tested positive for telomerase. None of the 100 controls (0%) expressed telomerase in their peritoneal washings.

Conclusions: Telomerase activity in peritoneal washings of patients treated for ovarian carcinoma and undergoing a second-look procedure may provide a means of increasing the sensitivity of such procedures for the detection of residual disease while maintaining a high level of specificity.