Role of CT in the management of recurrent ovarian cancer Journal Article
| Authors: | Funt, S. A.; Hricak, H.; Abu Rustum, N.; Mazumdar, M.; Felderman, H.; Chi, D. S. |
| Article Title: | Role of CT in the management of recurrent ovarian cancer |
| Abstract: | OBJECTIVE. The purpose of this study was to evaluate the potential role of preoperative CT in patients with recurrent ovarian cancer who undergo secondary cytoreductive surgery. MATERIALS AND METHODS. Preoperative CT examinations of 36 consecutive patients (age range, 30-75 years; mean age, 55 years) were reviewed retrospectively. Patients had recurrent ovarian cancer and secondary cytoreduction within a mean CT-surgery interval of 22 days (range, 2-69 days). The CT findings recorded were upper abdominal metastases (e.g., peritoneal carcinomatosis; perihepatic, perisplenic, gastrohepatic or gastrosplenic ligaments; gallbladder fossa; falciform ligament; lesser sac), lymphadenopathy (above or below the renal hilum), liver metastasis, large- and small-bowel obstruction, hydronephrosis, ascites, and the presence of a pelvic mass. CT findings and cancer antigen-125 (CA-125) levels were correlated with surgical resectability. RESULTS. At surgery, tumors in 27 patients were optimally debulked (residual disease of ≤ 1 cm) and in nine patients were nonresectable. Using multivariate analysis, hydronephrosis (odds ratio = 19.4, p = 0.03) and invasion of pelvic sidewall (odds ratio = 35.6, p = 0.006) were found to be most indicative of tumor nonresectability. The presence of small-bowel obstruction; nodal or perihepatic liver metastasis; ascites; peritoneal carcinomatosis; bladder, rectum, sigmoid colon, or vaginal involvement; or infrarenal paraaortic adenopathy; and the level of CA-125 were not strong indicators of tumor nonresectability. CONCLUSION. In patients with recurrent ovarian carcinoma considered for secondary cytoreductive surgery, preoperative CT can be helpful in identifying the extent of the disease and can be used as an adjunct to treatment planning and management decisions. |
| Keywords: | adult; clinical article; controlled study; treatment outcome; aged; middle aged; cancer surgery; retrospective studies; review; ascites; treatment planning; recurrent cancer; lymph node metastasis; paraaortic lymph node; preoperative evaluation; medical decision making; ovarian neoplasms; metastasis; computer assisted tomography; ovary cancer; neoplasm recurrence, local; tomography, x-ray computed; retrospective study; ovary; liver metastasis; tomography; tumor recurrence; ovary tumor; reoperation; pelvis tumor; gynecologic surgical procedures; radiography; ca 125 antigen; carcinomatous peritonitis; gynecologic surgery; lymphadenopathy; small intestine obstruction; hydronephrosis; colon obstruction; humans; human; female; priority journal |
| Journal Title: | American Journal of Roentgenology |
| Volume: | 182 |
| Issue: | 2 |
| ISSN: | 0361-803X |
| Publisher: | American Roentgen Ray Society |
| Date Published: | 2004-02-01 |
| Start Page: | 393 |
| End Page: | 398 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 14736669 |
| DOI/URL: | |
| Notes: | Am. J. Roentgenol. -- Cited By (since 1996):27 -- Export Date: 16 June 2014 -- CODEN: AJROA C2 - 14736669 -- Source: Scopus |
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