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The role of computed tomography in the assessment of tumour extent and the risk of residual disease after upfront surgery in advanced ovarian cancer (AOC)

Asp, Mihaela LU orcid ; Malander, Susanne LU orcid ; Wallengren, Nils-Olof LU ; Pudaric, Sonja LU ; Bengtsson, Johan LU orcid ; Sartor, Hanna LU and Kannisto, Päivi LU (2022) In Archives of Gynecology and Obstetrics
Abstract
Purpose
Epithelial ovarian cancer is usually diagnosed in the advanced stages. To choose the best therapeutic approach, an accurate preoperative assessment of the tumour extent is crucial.
This study aimed to determine whether the peritoneal cancer index (PCI), the amount of ascites, and the presence of cardiophrenic nodes (CPLNs) visualized by computed tomography (CT) can assess the tumour extent (S-PCI) and residual disease (RD) for advanced ovarian cancer (AOC) patients treated with upfront surgery.
Methods
In total, 118 AOC cases were included between January 2016 and December 2018 at Skåne University Hospital, Lund, Sweden. Linear regression and interclass correlation (ICC) analyses were used to determine the... (More)
Purpose
Epithelial ovarian cancer is usually diagnosed in the advanced stages. To choose the best therapeutic approach, an accurate preoperative assessment of the tumour extent is crucial.
This study aimed to determine whether the peritoneal cancer index (PCI), the amount of ascites, and the presence of cardiophrenic nodes (CPLNs) visualized by computed tomography (CT) can assess the tumour extent (S-PCI) and residual disease (RD) for advanced ovarian cancer (AOC) patients treated with upfront surgery.
Methods
In total, 118 AOC cases were included between January 2016 and December 2018 at Skåne University Hospital, Lund, Sweden. Linear regression and interclass correlation (ICC) analyses were used to determine the relationship between CT-PCI and S-PCI. The patients were stratified in complete cytoreductive surgery (CCS) with no RD or to non-CCS with RD of any size. The amount of ascites on CT (CT-ascites), CA-125 and the presence of radiological enlarged CPLNs (CT-CPLN) were analysed to evaluate their impact on estimating RD.
Results
CT-PCI correlated well with S-PCI (0.397; 95% CI 0.252–0.541; p < 0.001). The risk of RD was also related to CT-PCI (OR 1.069 (1.009–1.131), p < 0.023) with a cut-off of 21 for CT-PCI (0.715, p = 0.000). The sensitivity, specificity, positive predictive value and negative predictive value were 58.5, 70.3, 52.2 and 75.4%, respectively. CT-ascites above 1000 ml predicted RD (OR 3.510 (1.298–9.491) p < 0.013).
Conclusion

CT is a reliable tool to assess the extent of the disease in advanced ovarian cancer. Higher CT-PCI scores and large volumes of ascites estimated on CT predicted RD of any size. (Less)
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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Archives of Gynecology and Obstetrics
publisher
Springer
external identifiers
  • pmid:35235024
  • scopus:85125526706
ISSN
1432-0711
DOI
10.1007/s00404-022-06466-8
language
English
LU publication?
yes
id
6167a6f2-bc3f-4a37-8e01-99f49b5f13c6
date added to LUP
2022-03-03 09:26:39
date last changed
2022-11-08 17:26:19
@article{6167a6f2-bc3f-4a37-8e01-99f49b5f13c6,
  abstract     = {{Purpose<br/>Epithelial ovarian cancer is usually diagnosed in the advanced stages. To choose the best therapeutic approach, an accurate preoperative assessment of the tumour extent is crucial. <br/>This study aimed to determine whether the peritoneal cancer index (PCI), the amount of ascites, and the presence of cardiophrenic nodes (CPLNs) visualized by computed tomography (CT) can assess the tumour extent (S-PCI) and residual disease (RD) for advanced ovarian cancer (AOC) patients treated with upfront surgery.<br/>Methods<br/>In total, 118 AOC cases were included between January 2016 and December 2018 at Skåne University Hospital, Lund, Sweden. Linear regression and interclass correlation (ICC) analyses were used to determine the relationship between CT-PCI and S-PCI. The patients were stratified in complete cytoreductive surgery (CCS) with no RD or to non-CCS with RD of any size. The amount of ascites on CT (CT-ascites), CA-125 and the presence of radiological enlarged CPLNs (CT-CPLN) were analysed to evaluate their impact on estimating RD.<br/>Results<br/>CT-PCI correlated well with S-PCI (0.397; 95% CI 0.252–0.541; p &lt; 0.001). The risk of RD was also related to CT-PCI (OR 1.069 (1.009–1.131), p &lt; 0.023) with a cut-off of 21 for CT-PCI (0.715, p = 0.000). The sensitivity, specificity, positive predictive value and negative predictive value were 58.5, 70.3, 52.2 and 75.4%, respectively. CT-ascites above 1000 ml predicted RD (OR 3.510 (1.298–9.491) p &lt; 0.013).<br/>Conclusion<br/><br/>CT is a reliable tool to assess the extent of the disease in advanced ovarian cancer. Higher CT-PCI scores and large volumes of ascites estimated on CT predicted RD of any size.}},
  author       = {{Asp, Mihaela and Malander, Susanne and Wallengren, Nils-Olof and Pudaric, Sonja and Bengtsson, Johan and Sartor, Hanna and Kannisto, Päivi}},
  issn         = {{1432-0711}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Springer}},
  series       = {{Archives of Gynecology and Obstetrics}},
  title        = {{The role of computed tomography in the assessment of tumour extent and the risk of residual disease after upfront surgery in advanced ovarian cancer (AOC)}},
  url          = {{http://dx.doi.org/10.1007/s00404-022-06466-8}},
  doi          = {{10.1007/s00404-022-06466-8}},
  year         = {{2022}},
}