A Clinical and Computed Tomography Scan Correlation In Patients With Advanced Ovarian Carcinoma
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 8
Abstract
Background: Epithelial ovarian carcinoma (EOC) is the most lethal malignant disease; especially due to its advanced stage of diagnosis. Computed tomography (CT) scan screening and cancer antigen 125 are tried in patients for early diagnosis but do not to have an impact on the survival. CT scan studies preoperatively are being used to identify predictability of optimal or suboptimal cytoreduction patients with EOC. Materials and Methods: A retrospective study was conducted to correlate the CT scan findings and intra-operative findings of patients with advanced EOC of Stage III/IV undergoing cytoreduction. 42 patients undergoing surgical cytoreduction over a period of 9 years from a tertiary teaching hospital were included. Clinical data were obtained from earlier medical records. Pre-operative CT scan was done in all patients. Residual tumors identified measuring <1 cm were considered suboptimal cytoreduction. Results: A total of 42 patients matching the inclusion criteria were included. On pre-operative CT scans, omental extension to the stomach or spleen and inguinal or pelvic lymph nodes >2 cm were predictors of suboptimal cytoreduction. Optimal cytoreduction <1 cm residual disease was achieved in 17 (40.47%) patients. Involvement of both omental extension and inguinal or pelvic lymph nodes had a positive predictive value of 85.29% in cytoreduction. Conclusion: CT scan is the most valuable tool for the pre-operative prediction of successful resection of ovarian cancer during primary surgery. However, the CT-based pitfalls leading to suboptimal cytoreduction have to be identified with a larger study. The combination of omental extension to the stomach or spleen and involvement of inguinal or pelvic lymph nodes in pre-operative CT scans is considered predictive of suboptimal cytoreduction. These patients may be more appropriately treated with neoadjuvant chemotherapy followed by surgical cytoreduction
Authors and Affiliations
C M Sheethal
Keywords
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