Follow-up of the asymptomatic patient with ovarian cancer.

At present the optimal follow-up/monitoring strategy for the asymptomatic patient with advanced ovarian cancer after initial treatment remains undefined. Important considerations in the decision to take a more "passive" or "active" approach in follow-up include: (1) absence of data on the overall clinical utility of second-line ("salvage") therapy in ovarian cancer; (2) costs, morbidity, and mortality of possible monitoring and treatment strategies; and (3) patient preference for a particular approach. Currently, it must be concluded that there is no evidence that intensive investigative monitoring efforts in the asymptomatic patient exert a significant positive impact on overall survival, symptom-free survival, or quality of life. However, in carefully selected patients, such a strategy may be an appropriate management option, as long as individuals followed in this manner are informed of the limited data demonstrating the value of either intensive monitoring or therapy in this clinical setting.