Greater-omentum lesion-score (GOLS) as a predictor of residual disease in different regions of the peritoneal cavity in patients undergoing interval cytoreductive surgery for advanced ovarian cancer and its potential clinical utility
| Autor: | Mojgan Devouassoux-Shisheboran, Aditi Bhatt, Loma Parkih, Vahan Kepenkian, Praveen Kammar, Gaurav Goswami, Naoual Bakrin, Pascal Rousset, Sanket Mehta, Olivier Glehen, Sakina Shaikh, Snita Sinukumar |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Neoplasm Residual medicine.medical_treatment Carcinoma Ovarian Epithelial Lesion 03 medical and health sciences Peritoneal cavity 0302 clinical medicine Predictive Value of Tests medicine Humans Prospective Studies 030212 general & internal medicine Prospective cohort study Peritoneal Cavity Aged Neoplasm Staging Chemotherapy Receiver operating characteristic business.industry Cancer Cytoreduction Surgical Procedures General Medicine Middle Aged Greater omentum medicine.disease medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Conventional PCI Female Surgery Radiology medicine.symptom business Omentum |
| Zdroj: | European Journal of Surgical Oncology. 47:2925-2932 |
| ISSN: | 0748-7983 |
| DOI: | 10.1016/j.ejso.2021.05.028 |
| Popis: | Background and aim The greater omentum(GO) is a common site of residual disease in patients receiving neoadjuvant chemotherapy for advanced epithelial ovarian cancer. The presence of tumor in the GO could predict presence of disease in other peritoneal regions. The goal of this study was to perform a correlation between the greater-omentum lesion-score(GOLS) and presence of disease in different peritoneal regions and determine its potential utility in guiding interval cytoreductive surgery(CRS). Methods This prospective study included 134 patients undergoing interval CRS from July 1, 2018 to June 30, 2020. Each region of Sugarbaker's Peritobneal Cancer Index(PCI) was given a lesion score(LS) from 0 to 3 according to the diameter of the largest tumor in the region. The GOLS was recorded separately from other structures in the region. Correlation between the GOLS and surgical and pathological LS in each region was performed. Results As the GOLS increased, the incidence of disease(surgical LS) in other regions of the peritoneal cavity increased. Receiver operating characteristic(ROC) curves showed area under curve more than 80% for regions 1–2 and 7–8 indicating a high probability of disease in these regions in patients with GOLS 1–3. The positive predictive value(PPV) of preoperative imaging for GOLS was 95.7%. No cut-off of the GOLS could predict presence of disease on pathology with more than 70% accuracy. Conclusions Presence of disease in the GO warrants performing upper abdominal exploration and/or cytoreduction and interval CRS should be planned accordingly in these patients. Imaging has a high PPV in detecting disease in the GO. |
| Databáze: | OpenAIRE |
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