Thoracic metastasis in advanced ovarian cancer: Comparison between computed tomography and video-assisted thoracic surgery Journal Article
| Authors: | Mironov, O.; Sala, E.; Mironov, S.; Pannu, H.; Chi, D. S.; Hricak, H. |
| Article Title: | Thoracic metastasis in advanced ovarian cancer: Comparison between computed tomography and video-assisted thoracic surgery |
| Abstract: | Objective: To determine which computed tomography (CT) imaging features predict pleural malignancy in patients with advanced epithelial ovarian carcinoma (EOC) using video-assisted thoracic surgery (VATS), pathology, and cytology findings as the reference standard. Methods: This retrospective study included 44 patients with International Federation of Obstetrics and Gynecology (FIGO) stage III or IV primary or recurrent EOC who had chest CT ≤30 days before VATS. Two radiologists independently reviewed the CT studies and recorded the presence and size of pleural effusions and of ascites; pleural nodules, thickening, enhancement, subdiaphragmatic tumour deposits and supradiaphragmatic, mediastinal, hilar, and retroperitoneal adenopathy; and peritoneal seeding. VATS, pathology, and cytology findings constituted the reference standard. Results: In 26/44 (59%) patients, pleural biopsies were malignant. Only the size of left-sided pleural effusion (reader 1: rho= -0.39, p=0.01; reader 2: rho=-0.37, p=0.01) and presence of ascites (reader 1: rho=-0.33, p=0.03; reader 2: rho=-0.35, p=0.03) were significantly associated with solid pleural metastasis. Pleural fluid cytology was malignant in 26/35 (74%) patients. Only the presence (p=0.03 for both readers) and size (reader 1: rho=0.34, p=0.04; reader 2: rho=0.33, p=0.06) of right-sided pleural effusion were associated with malignant pleural effusion. Interobserver agreement was substantial (kappa=0.78) for effusion size and moderate (kappa=0.46) for presence of solid pleural disease. No other CT features were associated with malignancy at biopsy or cytology. Conclusion: In patients with advanced EOC, ascites and left-sided pleural effusion size were associated with solid pleural metastasis, while the presence and size of right-sided effusion were associated with malignant pleural effusion. No other CT features evaluated were associated with pleural malignancy. © 2011. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology. |
| Keywords: | adult; clinical article; controlled study; human tissue; aged; review; ascites; ovarian neoplasms; disease association; computer assisted tomography; image analysis; retrospective study; lung metastasis; ovary carcinoma; pleura effusion; cross-sectional study; pleura fluid; lymphadenopathy; pleural neoplasms; video assisted thoracoscopic surgery; tumor seeding; computed tomography; ascites fluid cytology; lung nodule; pleura biopsy; pleural effusion; malignant/diagnosis; thoracic surgery/video-assisted |
| Journal Title: | Journal of Gynecologic Oncology |
| Volume: | 22 |
| Issue: | 4 |
| ISSN: | 2005-0380 |
| Publisher: | Korean Soc Gynecology Oncology & Colposcopy |
| Date Published: | 2011-12-01 |
| Start Page: | 260 |
| End Page: | 268 |
| Language: | English |
| DOI: | 10.3802/jgo.2011.22.4.260 |
| PROVIDER: | scopus |
| PMCID: | PMC3254845 |
| PUBMED: | 22247803 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 April 2012" - "Source: Scopus" |
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