Detection of residual subclinical ovarian carcinoma after completion of adjuvant chemotherapy.
OBJECTIVE
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.


METHODS
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.
Nouriani
Mory
M
Division of Gynecologic Oncology, University of Southern California Keck School of Medicine, Los Angeles, California 90033, USA.
Bahador
Afshin
A
Berek
Jonathan S
JS
Cheng
Joan P
JP
Chi
Dennis S
DS
Cliby
William A
WA
Del Priore
Giuseppe
G
Dodson
Mark K
MK
Duggan
Bridgette D
BD
Gershenson
David M
DM
Lentz
Scott E
SE
Penson
Richard T
RT
Robinson
William R
WR
Rodriguez
Mildred
M
Roman
Lynda D
LD
Yu
Mimi C
MC
Zempolich
Karen
K
Dubeau
Louis
L
D000328:Adult; D001202:Ascitic Fluid / Q000473:pathology*; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D010533:Peritoneal Lavage; D010537:Peritoneum / Q000378:metabolism; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D019098:Telomerase / Q000235:genetics / Q000378:metabolism
D019098:Telomerase