TY - JOUR
T1 - A multicenter assessment of the ability of preoperative computed tomography scan and CA-125 to predict gross residual disease at primary debulking for advanced epithelial ovarian cancer
AU - Suidan, Rudy S.
AU - Ramirez, Pedro T.
AU - Sarasohn, Debra M.
AU - Teitcher, Jerrold B.
AU - Iyer, Revathy B.
AU - Zhou, Qin
AU - Iasonos, Alexia
AU - Denesopolis, John
AU - Zivanovic, Oliver
AU - Long Roche, Kara C.
AU - Sonoda, Yukio
AU - Coleman, Robert L.
AU - Abu-Rustum, Nadeem R.
AU - Hricak, Hedvig
AU - Chi, Dennis S.
N1 - Funding Information:
Quin Zhou and Alexia Iasonos are supported by a NIH grant (P30 CA008748).
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Objective To assess the ability of preoperative computed tomography scan and CA-125 to predict gross residual disease (RD) at primary cytoreduction in advanced ovarian cancer. Methods A prospective, non-randomized, multicenter trial of patients who underwent primary debulking for stage III–IV epithelial ovarian cancer previously identified 9 criteria associated with suboptimal (> 1 cm residual) cytoreduction. This is a secondary post-hoc analysis looking at the ability to predict any RD. Four clinical and 18 radiologic criteria were assessed, and a multivariate model predictive of RD was developed. Results From 7/2001–12/2012, 350 patients met eligibility criteria. The complete gross resection rate was 33%. On multivariate analysis, 3 clinical and 8 radiologic criteria were significantly associated with the presence of any RD: age ≥ 60 years (OR = 1.5); CA-125 ≥ 600 U/mL (OR = 1.3); ASA 3–4 (OR = 1.6); lesions in the root of the superior mesenteric artery (OR = 4.1), splenic hilum/ligaments (OR = 1.4), lesser sac > 1 cm (OR = 2.2), gastrohepatic ligament/porta hepatis (OR = 1.4), gallbladder fossa/intersegmental fissure (OR = 2); suprarenal retroperitoneal lymph nodes (OR = 1.3); small bowel adhesions/thickening (OR = 1.1); and moderate-severe ascites (OR = 2.2). All ORs were significant with p < 0.01. A ‘predictive score’ was assigned to each criterion based on its multivariate OR, and the rate of having any RD for patients who had a total score of 0–2, 3–5, 6–8, and ≥ 9 was 45%, 68%, 87%, and 96%, respectively. Conclusions We identified 11 criteria associated with RD, and developed a predictive model in which the rate of having any RD was directly proportional to a predictive score. This model may be helpful in treatment planning.
AB - Objective To assess the ability of preoperative computed tomography scan and CA-125 to predict gross residual disease (RD) at primary cytoreduction in advanced ovarian cancer. Methods A prospective, non-randomized, multicenter trial of patients who underwent primary debulking for stage III–IV epithelial ovarian cancer previously identified 9 criteria associated with suboptimal (> 1 cm residual) cytoreduction. This is a secondary post-hoc analysis looking at the ability to predict any RD. Four clinical and 18 radiologic criteria were assessed, and a multivariate model predictive of RD was developed. Results From 7/2001–12/2012, 350 patients met eligibility criteria. The complete gross resection rate was 33%. On multivariate analysis, 3 clinical and 8 radiologic criteria were significantly associated with the presence of any RD: age ≥ 60 years (OR = 1.5); CA-125 ≥ 600 U/mL (OR = 1.3); ASA 3–4 (OR = 1.6); lesions in the root of the superior mesenteric artery (OR = 4.1), splenic hilum/ligaments (OR = 1.4), lesser sac > 1 cm (OR = 2.2), gastrohepatic ligament/porta hepatis (OR = 1.4), gallbladder fossa/intersegmental fissure (OR = 2); suprarenal retroperitoneal lymph nodes (OR = 1.3); small bowel adhesions/thickening (OR = 1.1); and moderate-severe ascites (OR = 2.2). All ORs were significant with p < 0.01. A ‘predictive score’ was assigned to each criterion based on its multivariate OR, and the rate of having any RD for patients who had a total score of 0–2, 3–5, 6–8, and ≥ 9 was 45%, 68%, 87%, and 96%, respectively. Conclusions We identified 11 criteria associated with RD, and developed a predictive model in which the rate of having any RD was directly proportional to a predictive score. This model may be helpful in treatment planning.
KW - CA-125
KW - CT scan
KW - Gross residual disease
KW - Ovarian cancer
KW - Primary debulking
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U2 - 10.1016/j.ygyno.2017.02.020
DO - 10.1016/j.ygyno.2017.02.020
M3 - Article
C2 - 28209497
AN - SCOPUS:85012277316
SN - 0090-8258
VL - 145
SP - 27
EP - 31
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 1
ER -