Epithelial Ovarian Carcinoma

• Clinical evaluation every 2-4 months x 2 years, then every 3-6 months x 3 years; annually after 5 years
• Monitoring includes:
  • PE with pelvic exam
  • Genetic risk evaluation if not done yet
  • If elevated initially, CA-125 every visit
  • As indicated: CBC, chemistry profile, CT scan, MRI, PET-CT, PET, chest x-ray
• Long-term wellness care

• Dysgerminoma
  • 1st year: Every 2-3 months with PE, tumor markers¹; radiographic imaging²; every 3-4 months with abdominal/pelvic CT
  • 2nd year: Every 3-4 months with PE, tumor markers¹; radiographic imaging²; every 6 months with abdominal/pelvic CT
  • 3rd, 4th and 5 years: Every 6 months with PE, tumor markers¹; radiographic imaging²; every year with abdominal/pelvic CT
  • Beyond 5 years: Every year with PE, tumor markers¹; radiographic imaging²; abdominal/pelvic CT when clinically indicated
• Non-dysgerminoma
  • 1st year: Every 2 months with PE, tumor markers¹; radiographic imaging²; every 3-4 months with chest x-ray and abdominal/pelvic CT
  • 2nd year: Every 2 months with PE, tumor markers¹; radiographic imaging²; every 4-6 months with chest x-ray and abdominal/pelvic CT
  • 3rd, 4th and 5 years: Every 4-6 months with PE, tumor markers¹; radiographic imaging²; every 6-12 months with abdominal/pelvic CT
  • Beyond 5 years: Every year with PE, tumor markers¹; radiographic imaging²; abdominal/pelvic CT when clinically indicated

• PE when clinically indicated based on stage
  • Early stage/low risk - 6-12 months
  • High risk - 4-6 months
• Tumor markers¹ when clinically indicated or if applicable
• Radiographic imaging² only in patients with symptoms, elevated biomarkers or suspicious findings in PE