Document Detail


Accuracy and clinical relevance of computed tomography scan interpretation of peritoneal cancer index in colorectal cancer peritoneal carcinomatosis: a multi-institutional study.
MedLine Citation:
PMID:  20976729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Evaluation of peritoneal metastases by computed tomography (CT) scans is challenging and has been reported to be inaccurate.
METHODS: A multi-institutional prospective observational registry study of patients with peritoneal carcinomatosis from colorectal cancer was conducted and a subset analysis was performed to examine peritoneal cancer index (PCI) based on CT and intraoperative exploration.
RESULTS: Fifty-two patients (mean age 52.6 ± 12.4 years) from 16 institutions were included in this study. Inaccuracies of CT-based assessment of lesion sizes were observed in the RUQ (P = 0.004), LLQ (P < 0.0005), RLQ (P = 0.003), distal jejunum (P = 0.004), and distal ileum (P < 0.0005). When CT-PCI was classified based on the extent of carcinomatosis, 17 cases (33%) were underestimations, of which, 11 cases (21%) were upstaged from low to moderate, 4 cases (8%) were upstaged from low to severe, and 2 cases (4%) were upstaged from moderate to severe. Relevant clinical discordance where an upstage occurred to severe carcinomatosis constituted a true inaccuracy and was observed in six cases (12%).
CONCLUSIONS: The actual clinical impact of inaccuracies of CT-PCI was modest. CT-PCI will remain as a mandatory imaging tool and may be supplemented with other tools including positron emission tomography scan or diagnostic laparoscopy, in the patient selection for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
Authors:
J Esquivel; T C Chua; A Stojadinovic; J Torres Melero; E A Levine; M Gutman; R Howard; P Piso; A Nissan; A Gomez-Portilla; L Gonzalez-Bayon; S Gonzalez-Moreno; P Shen; J H Stewart; P H Sugarbaker; R M Barone; R Hoefer; D L Morris; A Sardi; R P Sticca
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of surgical oncology     Volume:  102     ISSN:  1096-9098     ISO Abbreviation:  J Surg Oncol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-26     Completed Date:  2010-12-08     Revised Date:  2012-04-24    
Medline Journal Info:
Nlm Unique ID:  0222643     Medline TA:  J Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  565-70     Citation Subset:  IM    
Affiliation:
Department of Surgical Oncology, St Agnes Hospital, Baltimore, Maryland 21229, USA. jesusesquivel@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Carcinoma / drug therapy,  radiography*,  secondary*,  surgery
Colorectal Neoplasms / pathology*
Humans
Laparotomy
Middle Aged
Neoplasm Staging
Patient Selection
Peritoneal Neoplasms / drug therapy,  radiography*,  secondary*,  surgery
Tomography, X-Ray Computed*
Grant Support
ID/Acronym/Agency:
K08 CA131482/CA/NCI NIH HHS
Comments/Corrections
Comment In:
J Surg Oncol. 2010 Nov 1;102(6):563-4   [PMID:  20976728 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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