A treatment selection protocol for recurrent ovarian cancer patients: The role of FDG-PET/CT and staging laparoscopy

A. Fagotti, F. Fanfani, C. Rossitto, D. Lorusso, A. M. De Gaetano, A. Giordano, G. Vizzielli, G. Scambia

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the best diagnostic and staging strategy for recurrent ovarian cancer. Methods: The negative predictive value, specificity, positive predictive value, sensitivity, and accuracy rates of the fluorine-18-fluorodeoxyglucose positive emission tomography computed tomography (FDG-PET/CT) and staging laparoscopy in identifying surgically treatable/untreatable patients are assessed in a consecutive series of 70 recurrent ovarian cancer cases. Moreover, the diagnostic performance of each staging procedure in the evaluation of the number of nodules is analyzed. Results: The negative predictive value of the FDG-PET/CT was 83.3%, whereas the positive predictive value was 76.9%. Specificity was 55.6%, whereas sensitivity was 93.0%. Accuracy rate was 78.6%. Negative predictive value, specificity, positive predictive value, sensitivity, and accuracy rate of staging laparoscopy were 88.9, 64.0, 80.8, 95.0 and 83.1%, respectively. Combined radiological and laparoscopic evaluation showed a negative predictive value of 88.9%, a specificity of 59.3%, a positive predictive value of 78.8%, a sensitivity of 95.3%, and an accuracy rate of 81.4%. The number of nodules identified by FDG-PET/CT corresponded in only 23 patients (40.3%) at laparotomy, whereas 15 of 30 patients were correctly diagnosed (50.0%) by staging laparoscopy. Conclusions: The combination of FDG-PET/CT and staging laparoscopy has a significant effect on the multimodal approach to the population of patients with recurrent ovarian cancer. Such techniques should be considered complementary, because of the potential of each one to identify a different setting of the disease.

Original languageEnglish
Pages (from-to)152-158
Number of pages7
JournalOncology
Volume75
Issue number3-4
DOIs
Publication statusPublished - Oct 2008

Keywords

  • FDG-PET/CT
  • Laparoscopy
  • Ovarian cancer, recurrent

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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