RT Journal Article
SR Electronic
T1 2022-RA-1348-ESGO Role of computed tomography (CT) scan based reporting system ‘PAUSE’ to predict surgical resectability in epithelial ovarian cancer
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP A327
OP A327
DO 10.1136/ijgc-2022-ESGO.696
VO 32
IS Suppl 2
A1 Seema Singhal
A1 Atul Sharma
A1 Ekta Dhamija
A1 Sunesh Kumar
A1 Jyoti Meena
A1 Rajesh Kumari
A1 Anju Singh
A1 Sarita Kumari
A1 Jayashree Natarajan
A1 Anu Sabarinath
A1 Amit Mandal
A1 Rudrika Chandra
A1 Romey Rai
A1 Dipanwita Banerjee
A1 Swati Tomar
A1 Sandeep Mathur
A1 Neerja Bhatla
YR 2022
UL http://ijgc.bmj.com/content/32/Suppl_2/A327.1.abstract
AB Introduction/Background A novel ‘PAUSE’ reporting system was devised for standardization of reporting of CT based PCI in peritoneal malignancies and, also to emphasize increased focus on areas which often make the difference between optimal and suboptimal cytoreduction. The aims of current study were to evaluate the efficacy of CT scan-based protocol i.e. ‘PAUSE’, in predicting the optimal and suboptimal cytoreduction in EOC, and also to assess the role of intraoperative use of telescope to improve surgical PCI.Methodology A prospective observational pilot study recruited 30 women with EOC undergoing primary debulking surgery. The CECT was evaluated in accordance with the ‘PAUSE’ protocol to assess resectability. Surgical PCI was calculated before surgery and was revised using intraoperative telescope. Agreement was done using kappa statistics and Bland-Altman agreement analysis.Results The agreement between CT-PCI and surgical PCI was of low degree. Higher CT-PCI scores correlated with suboptimal resection; disease in regions 1, 3, 9, 10, 11 and 12 was more predictive of surgical outcome. The overall sensitivity, specificity, PPV and NPV of PAUSE with regards to prediction of surgical resectability was 81.3%, 35.7%, 59.1% and 62.5%, respectively. Diagnostic accuracy of PAUSE was 60%. Amongst the components, the maximum accuracy to predict sub optimal CRS was of U1 lesions, small bowel and mesentery involvement (66.7%), followed by U2 and A (53.3% and 50% respectively). New lesions were identified in 6 (20%) patients in subdiaphragmatic areas and the lesser sac using intra operative telescope in open surgery.Conclusion ‘PAUSE’ did not show statistical significance with surgical outcome with modest diagnostic accuracy. Most useful parameters for prediction of surgical resectability, were the presence of U1/U2 lesions and the involvement of small intestine and mesentery; Presence of ascites (A component) was least predictive; thus, should not be used as a sole criterion.