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Usefulness of computed tomography in predicting cytoreductive surgical outcomes for ovarian cancer

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The objective of this study was to identify features of preoperative computed tomography (CT) scans that can best predict outcomes of primary cytoreductive surgery in ovarian cancer patients.

Methods

Preoperative CT scans of 98 patients were evaluated retrospectively. Multiple logistic regression analysis was used to develop two models.

Results

Although optimal surgical reduction was attempted in 98 patients, 12 had suboptimal results. Having tumor implants on the small or large bowel mesenteries (any size) or at other sites (cutoff index: ≥1 cm) was found to be significant (p < 0.001) for predicting a suboptimal cytoreduction outcome. Two predictive models were created using multiple logistic regression analysis; both consider diffuse peritoneal thickening (DPT), infrarenal para-aortic or pelvic lymph node involvement, a bowel encasement tumor (≥2 cm), and any tumor implants in the cul-de-sac as significant. Model 1 adds consideration to any tumors in the pelvic or retroperitoneum and has an accuracy of 90.8% for predicting a suboptimal surgery. Model 2 (accuracy of 93.9%) adds to the core of predictors the presence of tumor implants on the bowel mesenteries (≥2 cm), omental caking (≥2 cm), and ascites fluid.

Conclusion

Using specific CT findings from patients with ovarian cancer, we have devised two predictive models that have an accuracy of greater than 90% for predicting whether cytoreductive surgery will completely remove all tumor tissue, which should greatly aid in the differential decision-making as to whether to attempt cytoreductive surgery first, or to advance directly to neoadjuvant chemotherapy.

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Acknowledgments

The authors would like to thank G. S. Buzard for his constructive critiques and editing of our manuscript.

Conflict of interest

The authors declare no potential conflicts of interest.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan

    Kazuko Fujwara, Kiyoshi Yoshino, Takayuki Enomoto, Masami Fujita, Yutaka Ueda, Takashi Miyatake, Toshihiro Kimura, Miho Muraji & Tadashi Kimura

  2. Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan

    Masatoshi Hori

  3. Department of Internal Medicine, Akagi Mental Hospital, Gunma, Japan

    Haruyasu Fujita

  4. Department of Obstetrics and Gynecology, Osaka University Faculty of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan

    Takayuki Enomoto

Authors
  1. Kazuko Fujwara
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  2. Kiyoshi Yoshino
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  3. Takayuki Enomoto
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  4. Masami Fujita
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  5. Yutaka Ueda
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  6. Takashi Miyatake
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  7. Toshihiro Kimura
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  8. Miho Muraji
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  9. Haruyasu Fujita
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  10. Tadashi Kimura
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  11. Masatoshi Hori
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Corresponding author

Correspondence to Takayuki Enomoto.

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Fujwara, K., Yoshino, K., Enomoto, T. et al. Usefulness of computed tomography in predicting cytoreductive surgical outcomes for ovarian cancer. Arch Gynecol Obstet 284, 1501–1507 (2011). https://doi.org/10.1007/s00404-011-1864-3

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  • DOI: https://doi.org/10.1007/s00404-011-1864-3

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