Correlation of pre-operative CT findings with surgical & histological tumor dissemination patterns at cytoreduction for primary advanced and relapsed epithelial ovarian cancer: A retrospective evaluation

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Title: Correlation of pre-operative CT findings with surgical & histological tumor dissemination patterns at cytoreduction for primary advanced and relapsed epithelial ovarian cancer: A retrospective evaluation
Authors: Nasser, S
Lazaridis, A
Evangelou, M
Jones, B
Nixon, K
Kyrgiou, M
Gabra, H
Rockall, A
Fotopoulou, C
Item Type: Journal Article
Abstract: Objectives Computed tomography (CT) is an essential part of preoperative planning prior to cytoreductive surgery for primary and relapsed epithelial ovarian cancer (EOC). Our aim is to correlate pre-operative CT results with intraoperative surgical and histopathological findings at debulking surgery. Methods We performed a systematic comparison of intraoperative tumor dissemination patterns and surgical resections with preoperative CT assessments of infiltrative disease at key resection sites, in women who underwent multivisceral debulking surgery due to EOC between January 2013 and December 2014 at a tertiary referral center. The key sites were defined as follows: diaphragmatic involvement(DI), splenic disease (SI), large (LBI) and small (SBI) bowel involvement, rectal involvement (RI), porta hepatis involvement (PHI), mesenteric disease (MI) and lymph node involvement (LNI). Results A total of 155 patients, mostly with FIGO stage IIIC disease (65%) were evaluated (primary = 105, relapsed = 50). Total macroscopic cytoreduction rates were: 89%. Pre-operative CT findings displayed high specificity across all tumor sites apart from the retroperitoneal lymph node status, with a specificity of 65%. The ability however of the CT to accurately identify sites affected by invasive disease was relatively low with the following sensitivities as relating to final histology: 32% (DI), 26% (SI), 46% (LBI), 44% (SBI), 39% (RI), 57% (PHI), 31% (MI), 63% (LNI). Conclusion Pre-operative CT imaging shows high specificity but low sensitivity in detecting tumor involvement at key sites in ovarian cancer surgery. CT findings alone should not be used for surgical decision making.
Issue Date: 29-Aug-2016
Date of Acceptance: 18-Aug-2016
URI: http://hdl.handle.net/10044/1/43413
DOI: http://dx.doi.org/10.1016/j.ygyno.2016.08.322
ISSN: 1095-6859
Publisher: Elsevier
Start Page: 264
End Page: 269
Journal / Book Title: Gynecologic Oncology
Volume: 143
Issue: 2
Copyright Statement: © 2016, Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor/Funder: Ovarian Cancer Action
Funder's Grant Number: N/A
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
Obstetrics & Gynecology
Pre-operative imaging
Cr
Ovarian cancer
COMPUTED-TOMOGRAPHY
DEBULKING SURGERY
CONSECUTIVE PATIENTS
STAGE-III
CARCINOMA
MRI
PREDICTORS
RESECTION
BENEFIT
PET/CT
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
1114 Paediatrics And Reproductive Medicine
Publication Status: Published
Appears in Collections:Division of Surgery
Division of Cancer
Epidemiology, Public Health and Primary Care



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