Surgical outcome prediction in patients with advanced ovarian cancer using computed tomography scans and intraoperative findings

Kim, Ha-Jeong; Choi, Chel Hun; Lee, Yoo-Young; Kim, Tae-Joong; Lee, Jeong‐Won; Bae, Duk-Soo; Kim, Byoung-Gie

doi:10.1016/j.tjog.2013.10.041

Cited by 22 publications

(19 citation statements)

References 22 publications

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“…Due to reasonable costs and wide availability, CT is a commonly used imaging method in the preoperative evaluation, staging, and treatment planning of OC. However, it is insufficient to predict the correct stage as accuracy rates are reported between 50% to 92% in some series [8,11,13]. This may be due to the fact that CT evaluative capabilities for each anatomic region are different.…”

Section: Discussionmentioning

confidence: 99%

“…To date, several studies have attempted to establish a predictive preoperative model to estimate successful tumor resectability, as well as to find predictors of suboptimal cytoreduction [8,10,11,14]. Fujwara et al, aimed to identify features of preoperative CT scans which can predict the outcomes of primary cytoreductive surgery in OC patients most successfully.…”

Section: Discussionmentioning

confidence: 99%

“…perirectal-perivesical fat plan, bladder, retroperitoneal lymph node, small and large intestines, diaphragm, lesser sac, liver, mesentery, adenopathy above the renal vessels, etc.). Nevertheless, as might be expected, it does not always yield the same quality [5,9,11].…”

Section: Introductionmentioning

confidence: 94%

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Computed tomography as a predictor of the extent of the disease and surgical outcomes in ovarian cancer

Cerci

Sakarya²,

Yetimalar³

et al. 2016

Ginekol Pol

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Objectives: The aim of the present study is to determine the predictive value of Computed Tomography (CT), alone or in combination with serum CA-125 levels, for preoperative staging, detection of the extent of the disease, and surgical complications in patients with ovarian carcinoma. Material and methods:One hundred and fourteen patients diagnosed with ovarian carcinoma following an exploratory laparotomy with a preoperative CT scan, performed between January 2007 and June 2013, were enrolled in the study. Preoperative CT and intraoperative surgical findings were compared using 14 parameters and predictions of CT for gastrointestinal, genitourinary, and cardiovascular complications. All radiological features and clinical characteristics were analyzed statistically.Results: CT and surgical findings correlated (sensitivity/ specificity) as follows: uterine and tubal spread (66%/89%), cervical involvement (100%/80%), peritoneal nodulesincreased density-carcinomatosis (57%/93%), omental involvement (68%/95%), retroperitoneal involvement (25%/84%), ascites (85%/87%), perirectal and perivesical fat plan obliteration (43%/94%), liver metastasis (50%/91%), small and large bowel involvement (47%/95%), adnexal mass (94%/70%), and other metastases (47%/86%). Also, CT findings were found to be statistically insignificant for prediction of mesenteric involvement, bladder metastasis, and diaphragmatic involvement. The overall CT sensitivity and specificity at detecting intraoperative findings was 91% and 71%, respectively. We found a statistically significant correlation between intestinal involvement on CT and the necessity of additional surgical procedures. Conclusions:CT is a widely used imaging method in the preoperative evaluation of ovarian cancer. However, its predictive value, sensitivity and specificity differ, depending on the anatomical region.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Computed tomography as a predictor of the extent of the disease and surgical outcomes in ovarian cancer

Cerci

Sakarya²,

Yetimalar³

et al. 2016

Ginekol Pol

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“…Поскольку инструментальные методы исследования считаются основополагающими при планировании оперативного вмешательства, многие исследования были посвящены разработке моделей, позволяющих прогнозировать результаты хирургического лечения. Изучалось влияние ряда факторов, включая поражение диафрагмы, лимфатических узлов, «панцирного сальника», органов желудочно-кишечного тракта и т. д. Специфичность моделей на этапе разработки достигала 100 % [17][18][19]. Так Dowdy и соавторы в 2004 г. продемонстрировали, что наличие диффузного утолщения брюшины >4 мм в ≥2 зонах (например, диафрагма, передняя брюшная стенка, таз) и массивного асцита (≥2 / 3 КТ снимков брюшной полости) резко снижает вероятность достижения оптимальной циторедукции (p<0,0001).…”

Section: компьютерная магнитно-резонансная и позитронно-эмиссионная unclassified

Criteria for Selection of Patients With High Chance of Complete or Optimal Debulking in Advanced Ovarian Cancer

Румянцев¹,

Тюляндина²,

Pokataev³

et al. 2017

Zlokač. opuholi

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“…Therefore, CT imaging should not be used as a single tool to guide patient management. [19][20][21][22][23][24] The same applies to testing CA-125 levels, a specific cutoff of which has never been validated as a predictor of operability. We suggest that the limitations of all currently available tests to predict inoperability and overall surgical outcome be considered further.…”

mentioning

confidence: 99%

Value of Neoadjuvant Chemotherapy for Newly Diagnosed Advanced Ovarian Cancer: A European Perspective

Fotopoulou

Sehouli

Aletti

et al. 2017

JCO

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The timing of debulking surgery in advanced ovarian cancer (AOC) has been the focus of debate and controversy in the international community for almost a decade. [1][2][3][4] Although supporters of primary debulking surgery (PDS) advocate significantly better overall survival (OS) and progression-free survival rates, with even a significantly favorable impact on the patterns of relapse, 4 opponents argue higher morbidity in a highly heterogeneous and often fatal disease.1-3 For more than two decades, we have known that each 10% increase in maximal cytoreduction is associated with a 5.5% increase in median survival, even after controlling for all other known patient-and tumor-specific variables. 5,6 However, because of the unusual tumor biology and clinical behavior of AOC, with a typical diffuse peritoneal dissemination, in the majority of cases complete debulking is associated with multivisceral resections that require extensive surgical expertise, training, and infrastructural support to not lead to an exponential increase in morbidity. 7Neoadjuvant chemotherapy (NAC) and interval debulking surgery (IDS) have been considered as ways to reduce surgical morbidity; however, the oncologic safety of these approaches has never been proven in a maximal effort setting of high surgical expertise.2,3 The inconsistent quality of the surgical trials that have addressed this matter so far; the broad variation in practice nationally and internationally; and the still unanswered questions of fragility scores, biomarkers, and valid predictors of operability have led to strong polarization and controversy worldwide, which gives a clear signal of the need for further evidence.As a network of European institutions dedicated to highquality gynecologic oncology care, we address some key points about this highly controversial topic and express some serious concerns related to a potential patient's compromise through suboptimal therapeutic strategies. Our statement is timed to the recent publication of the Society of Gynecologic Oncology and ASCO statement about the use of NAC in AOC, which provides guidance on the optimal timing of surgery and identifies diagnostic tools that facilitate the patient selection process.

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Surgical outcome prediction in patients with advanced ovarian cancer using computed tomography scans and intraoperative findings

Cited by 22 publications

References 22 publications

Computed tomography as a predictor of the extent of the disease and surgical outcomes in ovarian cancer

Computed tomography as a predictor of the extent of the disease and surgical outcomes in ovarian cancer

Criteria for Selection of Patients With High Chance of Complete or Optimal Debulking in Advanced Ovarian Cancer

Value of Neoadjuvant Chemotherapy for Newly Diagnosed Advanced Ovarian Cancer: A European Perspective

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