BACKGROUND: This study evaluates the accuracy of computed tomography (CT) scoring of the peritoneal cancer index (PCI) and examines its association with surgical morbidity and outcomes in pseudomyxoma peritonei. METHODS: Forty-seven patients with pseudomyxoma peritonei had preoperative evaluation of CT scans and were treated with cytoreductive surgery and perioperative intraperitoneal chemotherapy. Their radiological PCI and intraoperative PCI were scored for determination of accuracy and for correlation with morbidity and outcomes. RESULTS: Accuracy in detecting peritoneal lesions regardless of size ranged from 51% to 85% in the abdominopelvic regions and 21% to 25% in the small intestinal regions. The sensitivity of CT detection of peritoneal implants ranged from 67% to 84% in the abdominopelvic regions and from 56% to 57% in the small intestinal regions. The specificity of CT detection of peritoneal lesions was 100% in all regions. Preoperative CT identification of larger peritoneal lesions in the right upper quadrant (P = 0.016), epigastrium (P = 0.003), left upper quadrant (P = 0.019), proximal jejunum (P = 0.022), distal jejunum (P = 0.022), and proximal ileum (P = 0.022) predicted development of severe complications. Similarly, larger peritoneal lesions in the right upper quadrant (P = 0.039), epigastrium (P = 0.024), right flank (P = 0.005), and right lower quadrant (P = 0.034) were negatively associated with disease-free survival, and the right upper quadrant (P = 0.037) was negatively associated with overall survival. CONCLUSIONS: Preoperative CT scan depicting extensive upper abdominal and small bowel disease predicts the presence of severe complications after cytoreduction. Extensive disease in the right upper quadrant seems to be associated with a poorer survival outcome.
BACKGROUND: This study evaluates the accuracy of computed tomography (CT) scoring of the peritoneal cancer index (PCI) and examines its association with surgical morbidity and outcomes in pseudomyxoma peritonei. METHODS: Forty-seven patients with pseudomyxoma peritonei had preoperative evaluation of CT scans and were treated with cytoreductive surgery and perioperative intraperitoneal chemotherapy. Their radiological PCI and intraoperative PCI were scored for determination of accuracy and for correlation with morbidity and outcomes. RESULTS: Accuracy in detecting peritoneal lesions regardless of size ranged from 51% to 85% in the abdominopelvic regions and 21% to 25% in the small intestinal regions. The sensitivity of CT detection of peritoneal implants ranged from 67% to 84% in the abdominopelvic regions and from 56% to 57% in the small intestinal regions. The specificity of CT detection of peritoneal lesions was 100% in all regions. Preoperative CT identification of larger peritoneal lesions in the right upper quadrant (P = 0.016), epigastrium (P = 0.003), left upper quadrant (P = 0.019), proximal jejunum (P = 0.022), distal jejunum (P = 0.022), and proximal ileum (P = 0.022) predicted development of severe complications. Similarly, larger peritoneal lesions in the right upper quadrant (P = 0.039), epigastrium (P = 0.024), right flank (P = 0.005), and right lower quadrant (P = 0.034) were negatively associated with disease-free survival, and the right upper quadrant (P = 0.037) was negatively associated with overall survival. CONCLUSIONS: Preoperative CT scan depicting extensive upper abdominal and small bowel disease predicts the presence of severe complications after cytoreduction. Extensive disease in the right upper quadrant seems to be associated with a poorer survival outcome.
Authors: Sean P Dineen; Richard E Royal; Marybeth S Hughes; Tara Sagebiel; Priya Bhosale; Michael Overman; Aurelio Matamoros; Paul F Mansfield; Keith F Fournier Journal: Ann Surg Oncol Date: 2015-02-20 Impact factor: 5.344
Authors: Sofie De Vuysere; Vincent Vandecaveye; Yves De Bruecker; Saskia Carton; Koen Vermeiren; Tim Tollens; Frederik De Keyzer; Raphaëla Carmen Dresen Journal: BMC Med Imaging Date: 2021-02-05 Impact factor: 1.930