Interval surgery in advanced stage ovarian cancer

Gounain, Fatima Zahra; Guennoun, Ahmed

doi:10.1016/j.ejogrb.2018.08.338

European Journal of Obstetrics & Gynecology and Reproductiv

2019

DOI: 10.1016/j.ejogrb.2018.08.338

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Interval surgery in advanced stage ovarian cancer

Fatima Zahra Gounain

Ahmed Guennoun

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“…11,12 Unresectable disease is mostly due to small bowel involvement, mesenteric infiltration, and bulky lymph nodes. 13 Full abdominal exploration can be difficult to obtain by laparoscopy due to adherences or tumor burden. Other authors consider that there are selected anatomic regions that cannot be optimally assessed by laparoscopy, such as the small bowel and hepatoduodenal ligament, and that disease extension to these regions is more predictive of complete debulking than the entire PCI.…”

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“…The Peritoneal Carcinomatosis Index (PCI) precisely describes anatomic distribution of peritoneal carcinomatosis and objectively quantifies the overall intra-abdominal tumor burden 11,12 . Unresectable disease is mostly due to small bowel involvement, mesenteric infiltration, and bulky lymph nodes 13 . Full abdominal exploration can be difficult to obtain by laparoscopy due to adherences or tumor burden.…”

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Performance of Multiparametric Functional Imaging to Assess Peritoneal Tumor Burden in Ovarian Cancer

et al. 2021

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Purpose The aim of the study was to evaluate the clinical utility of pretreatment 18F-FDG PET/CT with quantitative evaluation of peritoneal metabolic cartography in relation to staging laparoscopy for ovarian carcinomatosis. Patients and Methods A retrospective review of prospectively collected data from 84 patients with FIGO (International Federation of Gynecology and Obstetrics) stage IIIC to IV ovarian cancer was carried out. All patients had a double-blinded 18F-FDG PET/CT review. Discriminant capacity of metabolic parameters to identify peritoneal carcinomatosis in the 13 abdominal regions according to the peritoneal cancer index was estimated with area under the receiver operating characteristic curve (AUC). Results The metabolic parameter showing the best trade-off between sensitivity and specificity to predict peritoneal extension compared with peritoneal cancer index score was the metabolic tumor volume (MTV), with a Spearman ρ equal to 0.380 (P < 0.001). The AUC of MTV to diagnose peritoneal involvement in the upper abdomen (regions 1, 2, and 3) ranged from 0.740 to 0.765. MTV AUC values were lower in the small bowel regions (9–12), ranging from 0.591 to 0.681, and decreased to 0.487 in the pelvic region 6. 18F-FDG PET/CT also improved the detection of extra-abdominal disease, upstaging 35 patients (41.6%) from stage IIIC to IV compared with CT alone and leading to treatment modification in more than one third of patients. Conclusions 18F-FDG PET/CT metrics are highly accurate to reflect peritoneal tumor burden, with variable diagnostic value depending on the anatomic region. MTV is the most representative metabolic parameter to assess peritoneal tumor extension.

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Performance of Multiparametric Functional Imaging to Assess Peritoneal Tumor Burden in Ovarian Cancer

et al. 2021

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Interval surgery in advanced stage ovarian cancer

Cited by 1 publication

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Performance of Multiparametric Functional Imaging to Assess Peritoneal Tumor Burden in Ovarian Cancer

Performance of Multiparametric Functional Imaging to Assess Peritoneal Tumor Burden in Ovarian Cancer

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