Reproducibility of tumor measurements in ovarian cancer: a study of interobserver variability.
We evaluated the accuracy and interobserver variability of intraoperative tumor measurements in ovarian cancer. Thirty-four obstetrician-gynecologists, 26 gynecologic oncologists, and 12 residents estimated the size of a primary ovarian cancer and four metastases in a simulated patient at laparotomy. The validity of the model was rated from 1 (poor) to 10 (excellent) as 6.9 +/- 1.3 (range 4-10). Actual diameters and range of estimates were, respectively, primary ovarian tumor, 13 cm and 4 to 20 cm; plaque right pelvic sidewall, 8.5 cm and 0 to 12 cm; paraaortic nodes, 2 cm and 0 to 5 cm; right hemidiaphragm, 1 cm and 0.3 to 3 cm; and left hemidiaphragm, 5 cm and 2 to 7 cm. There was no significant difference in measurements between the three groups of surgeons. More surgeons underestimated than overestimated tumor diameters. Tumor measurements in individual patients are highly variable; interpretation of the surgical literature and ovarian cancer treatment protocols based on tumor volume are subject to significant measurement error.
Department of Obstetrics and Gynecology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts 01199.
M
M
Préfontaine
A T
AT
Gelfand
J T
JT
Donovan
J L
JL
Powell
D000704:Analysis of Variance; D005260:Female; D013502:General Surgery; D006176:Gynecology; D006801:Humans; D007396:Internship and Residency; D008875:Middle Aged; D015588:Observer Variation; D009774:Obstetrics; D010051:Ovarian Neoplasms / Q000473:pathology*; D010820:Physicians; D015203:Reproducibility of Results