RECURRENCE OF OVARIAN CANCER: POSSIBLE CAUSES, EARLY DETECTION

Abstract

Relevance: Early detection of ovarian cancer relapses and their treatment is among the most difficult in practical oncogynecology. Early diagnosis of ovarian cancer recurrence increases the effectiveness of treatment and gives a more favorable survival prognosis. The study aimed to show the possible cause of ovarian cancer recurrence and methods for early detection of relapses. Materials and methods: We systematically analyzed 31 cases of recurrent ovarian cancer treated at the Zhambyl Regional Center of Oncology and Surgery (Kazakhstan) in 2021-2022. We divided them by age, stage, period of relapse, type of histology, tumor grade, sites of recurrence, and symptoms of recurrence. Results: Ovarian cancer is most often detected in the late stages since, in the early stages, the disease is asymptomatic. Patients with advanced stages showed more relapses and distant metastases. Most ovarian cancer and this disease’s relapses are detected at 50-70 years old. The late stages give more distant and multiple relapses than the early stages and in terms of earlier. Moreover, according to histology results, mesenchymal tumors are more significant than epithelial and G3. Conclusion: The recurrence of ovarian cancer is an aggressively occurring disease. Based on the analysis work carried out, more than 70% of patients with recurrent ovarian cancer were aged 50-70 years, and the recurrence rate was higher at later stages (St III) or with a low-grade form of the tumor. All patients received platinum-based combination therapy. Targeted therapy (Bevacizumab) was administered in generalization of the process. More than 20% of all patients are resistant to platinum, whose relapse occurred before six months; the rest are sensitive to platinum with a later relapse. Based on everything, there is an increase in distant and multiple relapses in the late stages of ovarian cancer. This indicates the need to introduce screening programs based on cancer markers (CA-125) and diagnostic instrumental examinations (MRI/CT) to detect ovarian cancer in the early stages. After the treatment, all patients with this disease should be under active supervision, especially patients with low-grade tumors and in late stages.