Preoperative computed tomography does not predict resectability in peritoneal carcinomatosis - 05/05/14
, Walley J. Temple, M.D., F.R.C.S.C., F.A.C.S., Yarrow J. McConnell, M.D., F.R.C.S.C., Hisham Sultan, M.D., Lloyd A. Mack, M.D., F.R.C.S.C., F.A.C.S.Abstract |
Background |
Obtaining a complete cytoreduction in patients with peritoneal carcinomatosis (PC) is one of the most significant prognostic variables for long-term survival. This study explored features on preoperative computed tomography (CT) to predict unresectability.
Methods |
A retrospective case–control study was conducted of 15 patients with unresectable PC and 15 patients with completely resected PC matched by intraoperative peritoneal cancer index (PCI) and pathology type. Two surgical oncologists blindly analyzed all abdominopelvic CT scans.
Results |
PCI estimated on imaging was not higher in unresectable patients (P = .851) and significantly underestimated intraoperative PCI measurement (P = .003). No single concerning feature was associated with unresectability. However, patients with 2 or more concerning features were more likely to be unresectable (87.5% vs 36.4%, P = .035).
Conclusions |
Two or more concerning CT imaging features appear to be associated with a higher risk of unresectability in patients with PC. However, no specific imaging feature should exclude a patient from an attempted cytoreduction.
Le texte complet de cet article est disponible en PDF.Keywords : Peritoneal carcinomatosis, Cytoreduction, Computed tomography, Resectability
Plan
| There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs. |
Vol 207 - N° 5
P. 760-765 - mai 2014 Retour au numéro
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