PURPOSE: Identify features on preoperative computed tomography (CT) scans to predict suboptimal primary cytoreduction in patients treated for advanced ovarian cancer in institution A. Reciprocally cross validate the predictors identified with those from two previously published cohorts from institutions B and C. PATIENTS AND METHODS: Preoperative CT scans from patients with stage III/IV epithelial ovarian cancer who underwent primary cytoreduction in institution A between 1999 and 2005 were retrospectively reviewed by radiologists blinded to surgical outcome. Fourteen criteria were assessed. Crossvalidation was performed by applying predictive model A to the patients from cohorts B and C, and reciprocally applying predictive models B and C to cohort A. RESULTS: Sixty-five patients from institution A were included. The rate of optimal cytoreduction ( 1 cm residual disease) was 78%. Diaphragm disease and large bowel mesentery implants were the only CT predictors of suboptimal cytoreduction on univariate (P < .02) and multivariate analysis (P < .02). In combination (model A), these predictors had a sensitivity of 79%, a specificity of 75%, and an accuracy of 77% for suboptimal cytoreduction. When model A was applied to cohorts B and C, accuracy rates dropped to 34% and 64%, respectively. Reciprocally, models B and C had accuracy rates of 93% and 79% in their original cohorts, which fell to 74% and 48% in cohort A. CONCLUSION: The high accuracy rates of CT predictors of suboptimal cytoreduction in the original cohorts could not be confirmed in the cross validation. Preoperative CT predictors should be used with caution when deciding between surgical cytoreduction and neoadjuvant chemotherapy.
PURPOSE: Identify features on preoperative computed tomography (CT) scans to predict suboptimal primary cytoreduction in patients treated for advanced ovarian cancer in institution A. Reciprocally cross validate the predictors identified with those from two previously published cohorts from institutions B and C. PATIENTS AND METHODS: Preoperative CT scans from patients with stage III/IV epithelial ovarian cancer who underwent primary cytoreduction in institution A between 1999 and 2005 were retrospectively reviewed by radiologists blinded to surgical outcome. Fourteen criteria were assessed. Crossvalidation was performed by applying predictive model A to the patients from cohorts B and C, and reciprocally applying predictive models B and C to cohort A. RESULTS: Sixty-five patients from institution A were included. The rate of optimal cytoreduction ( 1 cm residual disease) was 78%. Diaphragm disease and large bowel mesentery implants were the only CT predictors of suboptimal cytoreduction on univariate (P < .02) and multivariate analysis (P < .02). In combination (model A), these predictors had a sensitivity of 79%, a specificity of 75%, and an accuracy of 77% for suboptimal cytoreduction. When model A was applied to cohorts B and C, accuracy rates dropped to 34% and 64%, respectively. Reciprocally, models B and C had accuracy rates of 93% and 79% in their original cohorts, which fell to 74% and 48% in cohort A. CONCLUSION: The high accuracy rates of CT predictors of suboptimal cytoreduction in the original cohorts could not be confirmed in the cross validation. Preoperative CT predictors should be used with caution when deciding between surgical cytoreduction and neoadjuvant chemotherapy.
Authors: Susan L Tucker; Kshipra Gharpure; Shelley M Herbrich; Anna K Unruh; Alpa M Nick; Erin K Crane; Robert L Coleman; Jamie Guenthoer; Heather J Dalton; Sherry Y Wu; Rajesha Rupaimoole; Gabriel Lopez-Berestein; Bulent Ozpolat; Cristina Ivan; Wei Hu; Keith A Baggerly; Anil K Sood Journal: Clin Cancer Res Date: 2014-04-22 Impact factor: 12.531
Authors: Iván Díaz-Padilla; Albiruni Ryan Abdul Razak; Lucas Minig; Marcus Q Bernardini; Josep María Del Campo Journal: Clin Transl Oncol Date: 2012-01 Impact factor: 3.405
Authors: Neil S Horowitz; G Larry Maxwell; Austin Miller; Chad A Hamilton; Bunja Rungruang; Noah Rodriguez; Scott D Richard; Thomas C Krivak; Jeffrey M Fowler; David G Mutch; Linda Van Le; Roger B Lee; Peter Argenta; David Bender; Krishnansu S Tewari; David Gershenson; James J Java; Michael A Bookman Journal: Gynecol Oncol Date: 2017-11-23 Impact factor: 5.482
Authors: G Ferrandina; G Sallustio; A Fagotti; G Vizzielli; A Paglia; E Cucci; A Margariti; L Aquilani; G Garganese; G Scambia Journal: Br J Cancer Date: 2009-09-08 Impact factor: 7.640