Follow-up study of the correlation between postoperative computed tomographic scan and primary surgeon assessment in patients with advanced ovarian, tubal, or peritoneal carcinoma reported to have undergone primary surgical cytoreduction to residual disease of 1 cm or smaller Journal Article
| Authors: | Chi, D. S.; Barlin, J. N.; Ramirez, P. T.; Levenback, C. F.; Mironov, S.; Sarasohn, D. M.; Iyer, R. B.; Dao, F.; Hricak, H.; Barakat, R. R. |
| Article Title: | Follow-up study of the correlation between postoperative computed tomographic scan and primary surgeon assessment in patients with advanced ovarian, tubal, or peritoneal carcinoma reported to have undergone primary surgical cytoreduction to residual disease of 1 cm or smaller |
| Abstract: | Introduction: We previously reported a 52% correlation between the primary surgeon's assessment and the postoperative computed tomographic (CT) scan findings of residual disease in patients reported to have undergone cytoreduction to residual disease of 1 cm or smaller. This is a follow-up analysis of survival and prognostic factors for patients who had concordant and discordant postoperative CT scan findings. Methods: Patients scheduled for primary cytoreductive surgery for presumed advanced ovarian carcinoma were offered enrollment in a prospective study evaluating the ability of preoperative CT scan to predict cytoreductive outcome. If cytoreduction to residual disease of 1 cm or smaller was reported, a CT scan was done 7 to 35 days postoperatively. The CT scan findings were graded by protocol radiologists using a qualitative analysis scale from 1 (normal) to 5 (definitely malignant). Results: From January 2001 to September 2006, 285 patients were enrolled; 67 patients were eligible. Postoperative CT scans confirmed the primary surgeon's assessment of no residual disease larger than 1 cm in 38 cases (57%). In 29 cases (43%), the radiologist found residual disease larger than 1 cm and reported it as probably or definitely malignant. Comparing concordant versus discordant findings, there was no significant difference in median progression-free survival (21 vs 17 months; P = 0.365) or overall survival (60 vs 43 months; P = 0.146). Age (P = 0.040), stage (P = 0.038), and residual disease of 0.5 mm or smaller versus 0.6 to 1.0 cm (P = 0.018) were significant for overall survival on multivariate analysis. Conclusions: On this follow-up analysis, only age, stage, and residual disease were significant prognostic factors for overall survival. Discordant findings between the primary surgeon's assessment and the postoperative CT scan findings of residual disease was not an independent prognostic factor. Copyright © 2010 by IGCS and ESGO. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; survival rate; major clinical study; overall survival; postoperative care; follow up; follow-up studies; neoplasm staging; prospective studies; ovarian cancer; cytoreductive surgery; ovarian neoplasms; progression free survival; computer assisted tomography; peritoneum cancer; neoplasm recurrence, local; peritoneal neoplasms; tumor volume; tomography, x-ray computed; radiologist; minimal residual disease; neoplasm, residual; surgeon; ovary carcinoma; adenocarcinoma, clear cell; cystadenocarcinoma, serous; platinum complex; taxane derivative; uterine tube carcinoma; fallopian tube neoplasms; qualitative analysis; computed tomographic scan; ct scan |
| Journal Title: | International Journal of Gynecological Cancer |
| Volume: | 20 |
| Issue: | 3 |
| ISSN: | 1048-891X |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2010-04-01 |
| Start Page: | 353 |
| End Page: | 357 |
| Language: | English |
| DOI: | 10.1111/IGC.0b013e3181d09fd6 |
| PUBMED: | 20375796 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 20 April 2011" - "CODEN: IJGCE" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work