COMPARATIVE CRITICAL ANALYSIS

Comparative Critical Analysis

Abstract

The overall incidence of ovarian cancer in the United States has remained constant in the last 30 years. The incidence increases with age and reaches maximum in the eighth decade of life. This cancer is very rare before reach this peak of 57 per 100,000 women 70 to 74 years. The overall risk of a woman developing ovarian cancer over their life is calculated as 1 on 70 (1.43%). In this paper we have critically analyse two papers on epithelial ovarian cancer. The objectives of this study is to determine the adequacy of surgical staging performed on surgically treated epithelial ovarian cancer patients with apparent early stage disease and to determine if receipt of surgical staging had an influence on survival.

Comparative Critical Analysis

Introduction

The epithelial ovarian cancer is a disease in which cells are malignant (cancer) in the tissue covering the ovary. The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus (the hollow organ, pear-shaped where a fetus grows). Each ovary is about the size and shape of an almond. The ovaries produce eggs and female hormones (chemicals that control the way certain cells or organs function) (Berek 2003, p685).

The ovarian cancers are a group of more or less serious tumors arising from the ovary. Is the most common epithelial ovarian cancer whose incidence is less than 5000 new cases per year. It is the 5th most common cancer in women (breast, colon, lung, corpus uteri). The incidence increases with age. The median age of diagnosis is 65. Only 7% of patients are premenopausal. Other malignant tumors of the ovary, there are germ cell tumors and borderline tumors. These tumors have a very special care and will not be addressed here.

The lack of specific symptoms that 60-75% of tumors are diagnosed at an advanced stage (III or IV). This late diagnosis explains the severity of its prognosis. The clinical signs are pelvic pain, sometimes transit disorders, vaginal bleeding. Mainly it is the presence of a "big belly" that alerts the patient (presence of ascites, fluid in the abdominal cavity). The clinical examination for direct (touching pelvic bloating tympanic) and indirect (lymph nodes, pleural fluid ) for the diagnosis. Laboratory tests include mainly looking for a fairly specific marker of ovarian cancer, CA125. The radiological assessment starts with an abdominal ultrasound and intra-vaginally. A pelvic MRI may improve pelvic expertise. Scanner thoraco-abdominopelvic Research an extra pelvic spread. A first laparoscopy may be necessary and will establish the diagnosis and verify the degree of peritoneal invasion (Burghardt 2004, p103).

Methods

The objectives of this study were to determine the adequacy of surgical staging performed on surgically treated epithelial ovarian cancer (EOC) patients with apparent early stage disease and to determine if receipt of surgical staging had an influence on survival. Results of the European randomized clinical trial called Adjuvant Chemotherapy in Ovarian Neoplasm (ACTION) conducted by the European Organization for Research ...