RT Journal Article
SR Electronic
T1 The Value of Postoperative/Preadjuvant Chemotherapy Computed Tomography in the Management of Patients With Ovarian Cancer
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 296
OP 301
DO 10.1097/IGC.0b013e31820aed49
VO 21
IS 2
A1 Evis Sala
A1 Lorenzo Mannelli
A1 Kenji Yamamoto
A1 Michelle Griffin
A1 Nyree Griffin
A1 Lee Grant
A1 Richard Parker
A1 Robin Crawford
YR 2011
UL http://ijgc.bmj.com/content/21/2/296.abstract
AB Objective: The objectives of the study were to compare the operative assessment of residual disease with the postoperative computed tomography (CT) findings in patients with ovarian cancer who underwent primary surgical cytoreduction or interval debulking surgery to residual disease 1 cm or less and to assess the effect of potential prognostic factors on patient survival.Methods: Patients scheduled for surgery and with an available postoperative CT were eligible for the study. Images were retrospectively analyzed in consensus by 2 radiologists. A 5-point qualitative scoring system was used to evaluate the CT findings (1 = tumor definitely absent, 2 = tumor probably absent, 3 = tumor possibly present, 4 = tumor probably present, 5 = tumor definitely present).Results: Between September 2005 and December 2008, 206 consecutive patients were enrolled; 51 were eligible. In 30 cases (59%), the postoperative CT findings correlated with the surgeon's assessment of residual disease. For the univariate analyses, the only significant prognostic factors associated with overall survival were no residual disease versus residual disease of less than 1 cm as assessed by the surgeon (hazard ratio [HR], 3.06; 95% confidence interval [CI], 1.29-7.27; P = 0.011) and no residual disease versus residual disease greater than 1 cm on CT (HR, 2.57; 95% CI, 1.02-6.48; P = 0.045). The interaction of surgical residual disease and stage 3 was significant (HR, 3.40; 95% CI, 1.42-8.16; P = 0.006) in the multivariate Cox model.Conclusions: There was only 59% correlation between the surgical assessment and postoperative CT findings of residual disease in patients reported to have undergone optimal surgery. Stage and residual disease as assessed by the surgeon were significant prognostic factors for overall survival. The value for postoperative CT may lie in those cases with small-volume residual disease (visible but reported as <1 cm) at surgery.