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80

NCCN Guidelines for Patients

®

:

Ovarian Cancer, Version 1.2017

6

Treatment guide Malignant germ cell tumors

Guide 27. Follow-up testing after treatment for malignant sex cord-stromal

tumors and malignant germ cell tumors

Follow-up tests

• Physical exam

• CA-125 blood test or other tumor markers (after 2 years for malignant germ cell tumors, only as needed)

• Chest x-ray; CT of the chest, abdomen, and pelvis; MRI; PET/CT; or PET as needed for germ cell tumors

only

• For concern of recurrence of malignant sex cord-stromal tumors and malignant germ cell tumors:

• CT of the chest, abdomen, and pelvis with contrast. Other imaging tests can be considered like chest

x-ray, MRI, PET/CT, or PET.

• CA-125 blood test or other tumor markers

Guide 27

covers follow-up tests that are

recommended every 2 to 4 months for 2 years for

women with malignant sex cord-stromal tumors and

malignant germ cell tumors. Those with malignant

sex cord-stromal tumors then will have a physical

exam and serum tumor marker test done every 6

months after 2 years. These tests may continue past

5 years if your doctor thinks they are necessary. A

follow-up physical exam is done once a year, after 2

years treatment for malignant germ cell tumors.

The physical exam and pelvic exam help your doctor

check for physical signs that the cancer has come

back. Such signs may include swelling or bloating

in your belly, abnormal lumps, or sudden changes

in weight. Blood tests to measure CA-125 or other

tumor markers are recommended to check for early

signs that the cancer has come back.

Imaging tests of your chest, abdomen, and pelvis

may be used to check if the cancer is present. An

x-ray, CT, MRI, PET, or PET/CT scan may be used

for germ cell tumors only. There are not enough

scientific data for doctors to recommend regular

imaging tests for malignant sex cord-stromal tumors.

If there is concern that the cancer has come back

(recurred) for both malignant sex cord-stromal

tumors and malignant germ cell tumors, a CT of the

chest, abdomen, and pelvis with contrast may be

considered. Other imaging tests can be also be done

and include a chest x-ray, MRI, PET/CT, or PET. Your

CA-125 level and other tumor markers may also be

measured at this time.