Serendipity

Incidental Findings of Borderline Ovarian Tumour or Ovarian Cancer -Real-World Data on Surgical and Oncological Outcome

https://tinyurl.com/5n8284dj

Sometimes ovarian cancer is found by chance during surgical procedures performed for other reasons. The standard of care for such cases is to undergo a repeat surgical procedure at a specialised surgical oncology centre. This study looks at real-world cases and seeks to determine whether this course of action results in worse outcomes. 

This retrospective survey of 390 patients at Bern Hospital during a 10-year period from 2010 showed 228 cases of either borderline ovarian tumour or ovarian cancer. The outcomes for these women were compared to those for women who were known to have ovarian cancer prior to single stage surgery at the same centre.

Apart from a small delay in starting chemo for those women who has a second operation, no difference in outcomes which include morbidity, mortality, and recurrence intervals was noted. 

Comorbidity, poisoned soil

Charlson’s comorbidity and remission outcomes in women diagnosed with epithelial ovarian cancer.

https://tinyurl.com/2hmnmvp9

Any surgery carries risk. Complex surgery such as that required for total clearance of ovarian cancer has a mortality of 4%. For some women this risk is increased by pre-existing medical conditions known as comorbidity.

This retrospective cohort study seeks to measure the risk increase in the presence of comorbidity. Using the Charlson comorbidity index, which shows associated significant pre-existing disease as a risk factor, even the lowest measure at more than 1 significantly decreased the prospect of complete remission and survival from ovarian cancer.

This means that patients who have one or more other major health issues are less likely to benefit from intensive primary treatment and that maybe alternative therapy, such as maintenance with personalised care should be considered?

AI, the way forward

LITERARY REVIEW OF ARTIFICIAL INTELLIGENCE IN OVARIAN CANCER: TRANSFORMING DIAGNOSIS, TREATMENT, AND FUTURE ADVANCEMENTS

https://tinyurl.com/yc85bx44

Artificial intelligence (AI) has the potential to change the management and improve survival for women with ovarian cancer. This review looks at what is possible now and what may be possible soon in the use of AI for this difficult disease.

Increasingly women with ovarian cancer are receiving personalised therapy base on the genetic, metabolic, and systemic nature of their cancer. More and more information cause problems with the understanding of the relevance and interconnection of the data. The great strength of AI is the ability to quickly correlate information and suggest appropriate measures to address the correct therapy path.

Using AI for the diagnosis of ovarian cancer will increase the sensitivity and avoid unnecessary intervention in some cases. Increasingly AI is being used for drug research, currently existing chemical compounds can be quickly scanned to determine likely effectiveness against ovarian cancer. Any relevant research can be processed and may provide alternative therapy suggestions. 

It seems likely that because of the complexity of ovarian cancer and the increasing amount of information being collected it will soon be essential to use AI as a standard of care. Caution is needed when using AI. There is increasing awareness of potential bias due to inequitable clinical trials and pre-conceived algorithms and constraints.

Suspicions confirmed

Differences in cancer rates among adults born between 1920 and 1990 in the USA: an analysis of population-based cancer registry data

https://tinyurl.com/wzaxy5w5

Anecdotal experience has suggested that cancer is becoming more common for younger patients. This suggests that lifestyle changes and environmental effects are causing more cancer. Using data from population-based cancer registry this study looks at the increase in cancer risk for younger cohorts.

Information is available from this huge study with data from more than 23 million patients, of whom more than 7 million developed cancers. Comparing cancer rates from 5-year birth cohorts showed that for 9 of the 34 different cancers included in the study there was an increase for patients born in the 1990 cohort compared to the 1955 cohort. The mortality has decreased, with better treatment options.

Some cancers notably smoking affected cancers such as lung cancer, show a decrease due to changed lifestyle. Ovarian cancer also is less, probably due to medical intervention with hormonal contraception.

Understanding of these changes suggest a need for modification of lifestyle and environmental factors with more research into underlying causes.