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Radiological predictors of cytoreductive outcomes in patients with advanced ovarian cancer

Objective To assess site of disease on preoperative computed tomography (CT) to predict surgical debulking in patients with ovarian cancer. Design Two‐phase retrospective cohort study. Setting West London Gynaecological Cancer Centre, UK. Population Women with stage 3 or 4, ovarian, fallopian or pri...

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Published in:BJOG : an international journal of obstetrics and gynaecology 2015-05, Vol.122 (6), p.843-849
Main Authors: Borley, J, Wilhelm‐Benartzi, C, Yazbek, J, Williamson, R, Bharwani, N, Stewart, V, Carson, I, Hird, E, McIndoe, A, Farthing, A, Blagden, S, Ghaem‐Maghami, S
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Language:English
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Summary:Objective To assess site of disease on preoperative computed tomography (CT) to predict surgical debulking in patients with ovarian cancer. Design Two‐phase retrospective cohort study. Setting West London Gynaecological Cancer Centre, UK. Population Women with stage 3 or 4, ovarian, fallopian or primary peritoneal cancer undergoing cytoreductive surgery. Methods Preoperative CT images were reviewed by experienced radiologists to assess the presence or absence of disease at predetermined sites. Multivariable stepwise logistic regression models determined sites of disease which were significantly associated with surgical outcomes in the test (n = 111) and validation (n = 70) sets. Main outcome measures Sensitivity and specificity of CT in predicting surgical outcome. Results Stepwise logistic regression identified that the presence of lung metastasis, pleural effusion, deposits on the large‐bowel mesentery and small‐bowel mesentery, and infrarenal para‐aortic nodes were associated with debulking status. Logistic regression determined a surgical predictive score which was able to significantly predict suboptimal debulking (n = 94, P = 0.0001) with an area under the curve (AUC) of 0.749 (95% confidence interval [95% CI]: 0.652, 0.846) and a sensitivity of 69.2%, specificity of 71.4%, positive predictive value of 75.0% and negative predictive value of 65.2%. These results remained significant in a recent validation set. There was a significant difference in residual disease volume in the test and validation sets (P 
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.12992