Peritoneal Cancer Indexes in Ovarian Carcinomatosis: Correlation Between CT and Intraoperative Results and Survival
International Journal of Clinical Oncology and Cancer Research
Volume 2, Issue 4, August 2017, Pages: 75-81
Received: Jan. 26, 2017;
Accepted: May 27, 2017;
Published: Aug. 1, 2017
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Lombardo Galera Sagrario, Department of Interventional Radiology, Reina Sofia University Hospital, Córdoba, Spain
Espejo Herrera Juan Jose, Department of Interventional Radiology, Reina Sofia University Hospital, Córdoba, Spain
López Redondo Celia, Department of Radiology, Reina Sofia University Hospital, Córdoba, Spain
Pérez Montilla Maria Eugenia, Department of Interventional Radiology, Reina Sofia University Hospital, Córdoba, Spain
Muñoz Casares Francisco Cristobal, Department of Oncologic Surgery, Reina Sofia University Hospital, Córdoba, Spain
Zurera Tendero Luis Jesus, Department of Interventional Radiology, Reina Sofia University Hospital, Córdoba, Spain
The aim of this study is to value the performance of computed tomography (CT) for the detection of ovarian peritoneal carcinomatosis (PC). We review retrospectively abdominopelvic CT and compare them with surgical reports to value the correlation between surgical and radiological PC indexes and survey. We compare the peritoneal tumor implants detected on CT performed before surgery with pathology results obtained after surgery. 47 patients with an average age of 58 years are investigated. Tumor localization and size are documented applying Sugarbaker´s Peritoneal Carcinomatosis Index (PCI) in both, radiological and surgical investigations, which divide the entire abdominal and intestinal regions into 13 spaces. In each one, the bigger visible lesion is measured and scored between 0 and 3. In our study, the correlation of Pearson shows there is a moderate correlation between the findings of the PCI obtained in the TC and surgical findings, appreciating a general low correlation in all regions, although the better results belong to regions 1, 2, 0 and 10. Also we observed a lower survival to greater PCI regarding carcinomatosis index in both TC and surgery. All patients received systemic chemotherapy before surgery, so its effect on the size of the peritoneal implants could explain the low correlation. In conclusion, we can consider that TC is a useful tool for the planning of the surgery and the preoperative treatments. The peritoneal cancer index is a significant index of survival in ovarian cancer patients and by using PCI a detailed evaluation of the peritoneal spread is possible being useful as a prognostic factor.
Lombardo Galera Sagrario,
Espejo Herrera Juan Jose,
López Redondo Celia,
Pérez Montilla Maria Eugenia,
Muñoz Casares Francisco Cristobal,
Zurera Tendero Luis Jesus,
Peritoneal Cancer Indexes in Ovarian Carcinomatosis: Correlation Between CT and Intraoperative Results and Survival, International Journal of Clinical Oncology and Cancer Research.
Vol. 2, No. 4,
2017, pp. 75-81.
Modugno F, Edwards R. Ovarian Cancer: Prevention, Detection and Treatment of the Disease and Its Recurrence Molecular Mechanisms and Personalized Medicine Meeting Report. Int J Gynecol Cancer 2012; 22: 45- 57.
Archer AG, Sugarbaker PH, Jelinek JS. Radiology of peritoneal carcinomatosis. Cancer Treat Res. 1996; 82: 263-88.
Chang-Yun L, Yonemura Y, Ishibashi H, Sako S, Tsukiyama G, Kitai T, et al. Evaluation of preoperative computed tomography in estimating peritoneal cancer index in peritoneal carcinomatosis. Gan to Kagaku Ryoho. 2011; 38: 2060-4.
Levy AD, Shaw JC, Sobin LH. From the Archives of the AFIP Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation. Radio Graphics 2009; 29: 347-73.
Cragun JM. Screening for ovarian cancer. Cancer Control. 2011; 18: 16-21.
Mazzei MA, Khader L, Cirigliano A, Cioffi Squitieri N, Guerrini S, Forzoni B, et al. Accuracy of MDCT in the preoperative definition of Peritoneal Cancer Index (PCI) in patients with advanced ovarian cancer who underwent peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC). Abdom Imaging. 2013; 38: 1422– 30.
Muñoz-Casares FC, Rufián S, Rubio MJ, Lizárraga E, Díaz-Iglesias C, Aranda E, et al. Treatment of peritoneal carcinomatosis from ovarian cancer. Present, future directions and proposals. Clin Transl Oncol. 2007; 9; 652-62.
Nougaret S, Addley HC, Colombo PE, Fujii S, Al Sharif SS, Tirumani SH, et al Ovarian carcinomatosis: how the radiologist can help plan the surgical approach. Radiographics. 2012; 32: 1775-800.
Pannu HK, Bristow RE, Montz FJ, Fishman EK. Multidetector CT of Peritoneal Carcinomatosis from Ovarian Cancer. Radio Graphics. 2003; 23: 687-701.
Jacquet P, Sugarbaker PH. Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. Cancer Treat Res. 1996; 82: 359–74.
Cotte E, Passot G, Gilly FN, Glehen O. Selection of patients and staging of peritoneal surface malignancies. World J Gastrointest Oncol. 2010; 15: 31-5.
Esquivel J, Sticca R, Sugarbaker P, Levine E, Yan TD, Alexander R, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin: a consensus statement. Society of Surgical Oncology. Ann Surg Oncol. 2007; 14: 128–33.
Verwaal VJ, Kusamura S, Baratti D, Deraco M. The eligibility for local-regional treatment of peritoneal surface malignancy. J Surg Oncol. 2008; 98: 220–22.
Nelson RC, Chezmar JL, Hoel MJ, Buck DR, Sugarbaker PH. Peritoneal carcinomatosis preoperative CT with intraperitoneal contrast material. Radiology. 1992; 182: 33-8.
Tempany CM, Zou KH, Silverman SG, Brown DL, Kurtz AB, McNeil BJ. Staging of advanced ovarian cancer: comparison of imaging modalities– report from the Radiological Diagnostic Oncology Group. Radiology. 2000; 215: 761-7.
Duhr C, Kenn W, Kickuth R, Kerscher AG, Germer CT, Hahn D, et al. Optimizing of preoperative computed tomography for diagnosis in patients with peritoneal carcinomatosis. World Journal of Surgical Oncology. 2011; 9: 171.
Chandrashekhara SH, Thulkar S, Srivastava DN, Kumar L, Hariprasad R, Kumar S, et al. Pre-operative evaluation of peritoneal deposits using multidetector computed tomography in ovarian cancer. The British Journal of Radiology. 2011; 84: 38–43.
Buy JN, Moss AA, Ghossain MA, Sciot C, Malbec L, Vadrot D, et al. Peritoneal implants from ovarian tumours: CT findings. Radiology 1988; 169: 691–4.
Franiel T, Diederichs G, Engelken F, Elgeti T, Rost J, Rogalla P. Multidetector CT in peritoneal carcinomatosis: diagnostic role of thin slices and multiplanar reconstructions. Abdominal Imaging 2009, 34: 49-54.
Metser U, Jones C, Jacks LM, Bernardini MQ, Ferguson S. Identification and Quantification of Peritoneal Metastases in Patients With Ovarian Cancer With Multidetector Computed Tomography Correlation With Surgery and Surgical Outcome. Int J Gynecol Cancer. 2011; 21: 1391-8.
Spiliotis J, Halkia EE, Kalantzi N, Giassas S, Lianos E, Efstathiou E, et al.. Mapping the location of peritoneal metastases using the peritoneal cancer index and the correlation with overall survival: a retrospective study. J BUON. 2015 May; 20 Suppl 1: S64-70.
Tentes AA, Tripsiannis G, Markakidis SK, Karanikiotis CN, Tzegas G, Georgiadis G, et al. Peritoneal cancer index: a prognostic indicator of survival in advanced ovarian cancer. European Journal of surgical oncology 2003, 29: 69.
Rhonda L Harmon and Paul H Sugarbaker. Prognostic indicators in peritoneal carcinomatosis from gastrointestinal cancer. International Seminars in Surgical Oncology 2005; 2: 3.
Ansell SM, Rapoport BL, Falkson G, Raats JI, Moeken CM. Survival determination in patients with advanced ovarian cancer. Gynecol Oncol 1993; 30: 215-20.
Swenerton KD, Hislop TG, Spinelli J, LeRiche JC, Yang N, Boyes DA. Ovarian carcinoma: a multivariante analysis of prognostic factors. Obstet Gynecol 1985; 65: 264-9.