A multicenter assessment of the ability of preoperative computed tomography scan and CA-125 to predict gross residual disease at primary debulking for advanced epithelial ovarian cancer Journal Article

   

Authors:	Suidan, R. S.; Ramirez, P. T.; Sarasohn, D. M.; Teitcher, J. B.; Iyer, R. B.; Zhou, Q.; Iasonos, A.; Denesopolis, J.; Zivanovic, O.; Long Roche, K. C.; Sonoda, Y.; Coleman, R. L.; Abu-Rustum, N. R.; Hricak, H.; Chi, D. S.
Article Title:	A multicenter assessment of the ability of preoperative computed tomography scan and CA-125 to predict gross residual disease at primary debulking for advanced epithelial ovarian cancer
Abstract:	Objective To assess the ability of preoperative computed tomography scan and CA-125 to predict gross residual disease (RD) at primary cytoreduction in advanced ovarian cancer. Methods A prospective, non-randomized, multicenter trial of patients who underwent primary debulking for stage III–IV epithelial ovarian cancer previously identified 9 criteria associated with suboptimal (> 1 cm residual) cytoreduction. This is a secondary post-hoc analysis looking at the ability to predict any RD. Four clinical and 18 radiologic criteria were assessed, and a multivariate model predictive of RD was developed. Results From 7/2001–12/2012, 350 patients met eligibility criteria. The complete gross resection rate was 33%. On multivariate analysis, 3 clinical and 8 radiologic criteria were significantly associated with the presence of any RD: age ≥ 60 years (OR = 1.5); CA-125 ≥ 600 U/mL (OR = 1.3); ASA 3–4 (OR = 1.6); lesions in the root of the superior mesenteric artery (OR = 4.1), splenic hilum/ligaments (OR = 1.4), lesser sac > 1 cm (OR = 2.2), gastrohepatic ligament/porta hepatis (OR = 1.4), gallbladder fossa/intersegmental fissure (OR = 2); suprarenal retroperitoneal lymph nodes (OR = 1.3); small bowel adhesions/thickening (OR = 1.1); and moderate-severe ascites (OR = 2.2). All ORs were significant with p < 0.01. A ‘predictive score’ was assigned to each criterion based on its multivariate OR, and the rate of having any RD for patients who had a total score of 0–2, 3–5, 6–8, and ≥ 9 was 45%, 68%, 87%, and 96%, respectively. Conclusions We identified 11 criteria associated with RD, and developed a predictive model in which the rate of having any RD was directly proportional to a predictive score. This model may be helpful in treatment planning. © 2017 Elsevier Inc.
Keywords:	ovarian cancer; ca-125; ct scan; primary debulking; gross residual disease
Journal Title:	Gynecologic Oncology
Volume:	145
Issue:	1
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2017-04-01
Start Page:	27
End Page:	31
Language:	English
DOI:	10.1016/j.ygyno.2017.02.020
PROVIDER:	scopus
PUBMED:	28209497
PMCID:	PMC5387995
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85012277316&doi=10.1016%2fj.ygyno.2017.02.020&partnerID=40&md5=fc3df832b3ebd602b755ff152297d0c0
Notes:	Article -- Export Date: 4 April 2017 -- Source: Scopus

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