Comparison between ultrasound and histopathological evaluation in ovarian cancer patients with complete clinical remission

The histopathological findings at second-look laparotomy in 20 patients with complete clinical remission of epithelial ovarian cancer were compared with the findings at preoperative ultrasound (US) examination. Discrepancies between pelvic US and histological findings occurred in 4/20 (20%) of the patients, and both the specificity and negative predictive value of US were 89%. Of the two false-negative studies, one showed only microscopic disease and the other showed a 0.5-cm nodule. The results of the two false-positive studies were due to postoperative scarring and adhesions, respectively. Obscuring intestinal gas precluded assessment of para-aortic nodes in 10 of 16 patients in which data from abdominal (US) evaluation were available. Although the status of residual gynecological organs could be determined in most cases, the study shows that US cannot replace second-look laparotomy.