| Accuracy and clinical relevance of computed tomography scan interpretation of peritoneal cancer index in colorectal cancer peritoneal carcinomatosis: a multi-institutional study. | |
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MedLine Citation:
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PMID: 20976729 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Evaluation Studies; Journal Article; Multicenter Study |
Journal Detail:
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Title: Journal of surgical oncology Volume: 102 ISSN: 1096-9098 ISO Abbreviation: J Surg Oncol Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-26 Completed Date: 2010-12-08 Revised Date: 2012-04-24 |
Medline Journal Info:
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Nlm Unique ID: 0222643 Medline TA: J Surg Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 565-70 Citation Subset: IM |
Affiliation:
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Department of Surgical Oncology, St Agnes Hospital, Baltimore, Maryland 21229, USA. jesusesquivel@yahoo.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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K08 CA131482/CA/NCI NIH HHS |
| Comments/Corrections | |
Comment In:
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J Surg Oncol. 2010 Nov 1;102(6):563-4
[PMID:
20976728
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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