Diagnostic accuracy of CT in assessing extra-regional lymphadenopathy in pancreatic and peri-ampullary cancer: a systematic review and meta-analysis
| Autor: | Hjalmar C. van Santvoort, Dorine S.J. Tseng, Nicolaas P.A. Zuithoff, Maarten S. van Leeuwen, Marc G. Besselink, Samira Fegrachi, I. Quintus Molenaar, Inne H.M. Borel Rinkes |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Ampulla of Vater
medicine.medical_specialty medicine.diagnostic_test business.industry Cancer Diagnostic accuracy Computed tomography medicine.disease Pancreaticoduodenectomy Pancreatic Neoplasms medicine.anatomical_structure Oncology Predictive Value of Tests Lymphatic Metastasis Meta-analysis Pancreatic cancer medicine Humans Surgery Lymph Radiology Tomography X-Ray Computed business Lymph node Cohort study |
| Zdroj: | Surgical oncology. 23(4):229-235 |
| ISSN: | 0960-7404 |
| DOI: | 10.1016/j.suronc.2014.10.005 |
| Popis: | Objectives Computed tomography (CT) is the most widely used method to assess resectability of pancreatic and peri-ampullary cancer. One of the contra-indications for curative resection is the presence of extra-regional lymph node metastases. This meta-analysis investigates the accuracy of CT in assessing extra-regional lymph node metastases in pancreatic and peri-ampullary cancer. Methods We systematically reviewed the literature according to the PRISMA guidelines. Studies reporting on CT assessment of extra-regional lymph nodes in patients undergoing pancreatoduodenectomy were included. Data on baseline characteristics, CT-investigations and histopathological outcomes were extracted. Diagnostic accuracy, positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity were calculated for individual studies and pooled data. Results After screening, 4 cohort studies reporting on CT-findings and histopathological outcome in 157 patients with pancreatic or peri-ampullary cancer were included. Overall, diagnostic accuracy, specificity and NPV varied from 63 to 81, 80–100% and 67–90% respectively. However, PPV and sensitivity ranged from 0 to 100% and 0–38%. Pooled sensitivity, specificity, PPV and NPV were 25%, 86%, 28% and 84% respectively. Conclusions CT has a low diagnostic accuracy in assessing extra-regional lymph node metastases in pancreatic and peri-ampullary cancer. Therefore, suspicion of extra-regional lymph node metastases on CT alone should not be considered a contra-indication for exploration. |
| Databáze: | OpenAIRE |
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