Is postoperative computed tomography evaluation a prognostic indicator in patients with optimally debulked advanced ovarian cancer?

Domenica Lorusso, Italo Sarno, Violante Di Donato, Antonella Palazzo, Elena Torrisi, Laura Pala, Alfonso Marchiano, Francesco Raspagliesi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To compare the surgeon's intraoperative assessment of residual tumor (RT) disease with that identified on postoperative computed tomography (CT) in patients undergoing optimal primary surgical cytoreduction (RT

Methods: Patients with FIGO stage III-IV ovarian cancer treated at the Gynecologic Oncology Unit of the National Cancer Institute between November 2011 and March 2013, who underwent optimal primary cytoreduction and were entered in prospective controlled clinical trials requiring a baseline postoperative CT evaluation within 30 days, were enrolled. All CT scans were reviewed by a dedicated radiologist to evaluate RT. Median follow-up was 16 months.

Results: 64 out of 160 patients met the eligibility criteria. RT = 0, 0.1 <RT <0.5 cm, and 0.6 <RT <1 cm was reported in 53 (82.8%), 9 (14.1%) and 2 (3.1%) cases, respectively. Postoperative CT disagreed with RT in 13 out of 64 (20.3%) cases. Progression-free survival (PFS) of patients with a positive and negative postoperative CT scan of RT was 5 months (95% CI 1-15 months) and 28 months (95% CI 2-46 months), respectively (p <0.0001). Evidence of the disease using postoperative CT was an independent prognostic factor in multivariate analysis (HR = 8.87, 95% CI = 3.23-24.31, p <0.0001).

Conclusions: Evidence of the disease using postoperative CT was associated with a significant decrease in PFS in patients who underwent optimal primary cytoreduction. RT status as evaluated with early postoperative CT may have an important role in prognostic assessment.

Original languageEnglish
Pages (from-to)293-299
Number of pages7
JournalOncology
Volume87
Issue number5
DOIs
Publication statusPublished - Nov 19 2014

Keywords

  • Optimal primary cytoreduction
  • Ovarian cancer
  • Postoperative computed tomography
  • Prognostic factor
  • Surgical cytoreduction

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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