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What is the Optimal Preoperative Imaging Modality for Assessing Peritoneal Cancer Index? An Analysis From the United States HIPEC Collaborative.

Published on Mar 1, 2020in Clinical Colorectal Cancer3.176
· DOI :10.1016/J.CLCC.2019.12.002
Rachel M. Lee1
Estimated H-index: 1
(Emory University),
Mohammad Y. Zaidi4
Estimated H-index: 4
(Emory University)
+ 25 AuthorsMaria C. Russell16
Estimated H-index: 16
(Emory University)
Abstract
Abstract Background Radiographic prediction of PCI can improve patient selection for cytoreductive surgery. We aimed to determine the correlation of CT-predicted PCI (CT-PCI) and MRI-predicted PCI (MRI-PCI) with intraoperative-PCI, and if a preoperative-PCI cutoff is associated with incomplete cytoreduction. Patients and Methods Patients from the US HIPEC Collaborative (2000-17) with appendiceal, colorectal, or peritoneal mesothelioma (PM) histology who underwent cytoreductive surgery were included. Pearson correlation coefficients were used to determine correlation between preoperative and intraoperative-PCI values. Fisher r-to-z transformation was used to compare correlations. Results 488 patients were included. 34% had non-invasive appendiceal, 30% invasive appendiceal, 28% colorectal, and 8% PM histology. CT-PCI was correlated with intraoperative-PCI for patients with non-invasive and invasive appendiceal, and colorectal histologies (r=0.689, 0.554, 0.571; all p Conclusions In this multi-institutional cohort, CT and MRI-PCI correlate well with intraoperative-PCI. MRI appears to be superior for invasive appendiceal and peritoneal mesothelioma. External validation in a larger population is needed.
  • References (17)
  • Citations (2)
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References17
Newest
#1Vignesh Narasimhan (University of Melbourne)H-Index: 2
#2Toan Pham (University of Melbourne)H-Index: 2
Last. Alexander G. Heriot (University of Melbourne)H-Index: 40
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#1R. Dresen (Katholieke Universiteit Leuven)H-Index: 4
#2Sofie De Vuysere (Katholieke Universiteit Leuven)H-Index: 1
Last. Vincent Vandecaveye (Katholieke Universiteit Leuven)H-Index: 31
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Correct staging of patients with colorectal cancer is of utmost importance for the prediction of operability. Although computed tomography (CT) has a good overall performance, estimation of peritoneal cancer spread is a known weakness, a problem that cannot always be overcome by Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT); especially in infiltrative and miliary disease spread. Due to its high spatial and contrast resolution magnetic resonance ...
1 CitationsSource
#1Andrea Laghi (Sapienza University of Rome)H-Index: 46
#2Davide Bellini (Sapienza University of Rome)H-Index: 11
Last. Paolo Sammartino (Sapienza University of Rome)H-Index: 18
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Purpose Primary end point was to assess diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in detecting peritoneal metastases (PM). Secondary end points were determining the diagnostic sensitivity and specificity of CT in detecting PM according to the peritoneal cancer index (PCI), investigating correlations between radiological and surgical PCI, and comparing diagnostic yield of CT versus positron emission tomography (PET)/CT.
21 CitationsSource
#1Yufei LiangH-Index: 1
#2Guo-qi ZhengH-Index: 3
Last. Li ZhangH-Index: 1
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Background and Aim: Diffuse malignant peritoneal mesothelioma (DMPM) and peritoneal carcinomatosis (PC) have similar imaging in computer tomography (CT). We aimed to distinguish them. Methods: Computer tomography findings were evaluated in 48 DMPM and 47 PC for the peritoneal, mesenteric, omentum, lymph nodes, viscera infiltration, ascites and pleural plaques. Results: Two groups had no difference in terms of thickness, clinical manifestation, diameter of lymph nodes, ascites, and viscera infilt...
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#1Rahul RajeevH-Index: 5
#2Brittany KloosterH-Index: 2
Last. Kiran K. Turaga (MCW: Medical College of Wisconsin)H-Index: 25
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Complex surgical operations performed at centers of high volume have improved outcomes due to improved surgical proficiency, and betters systems of care including avoidance of errors. Cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemoperfusion (HIPEC), which has been shown to be an oncologically effective strategy for peritoneal carcinomatosis (PC), is one such procedure with significant morbidity and mortality. The learning curve to reach technical proficiency in CRS + HIPEC is...
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#1Andrew D. NewtonH-Index: 7
#2Edmund K. BartlettH-Index: 15
Last. Giorgos C. Karakousis (UPenn: University of Pennsylvania)H-Index: 29
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Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with prolonged survival for appropriately selected patients with peritoneal dissemination of abdominal malignancies. CRS and HIPEC has been criticized for perceived high rates of morbidity and mortality. Morbidity and mortality rates of CRS and HIPEC, however, do not appear dissimilar to those of other large abdominal surgeries, particularly when relevant patient and operative factors are accounted fo...
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#1Torkzad (UCL: University College London)H-Index: 1
#2N Casta (Uppsala University)H-Index: 1
Last. Haile Mahteme (Uppsala University)H-Index: 23
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BACKGROUND:To compare CT and MRI for peritoneal carcinomatosis index (PCI) assessment and to compare assessments made by the radiologist based on their experiences.METHOD AND MATERIALS:MRI and CT o ...
27 CitationsSource
#1Russell N. Low (Sharp Memorial Hospital)H-Index: 21
#2Robert M. Barone (Sharp Memorial Hospital)H-Index: 5
Last. Janelle Lucero (Sharp Memorial Hospital)H-Index: 1
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44 CitationsSource
#1Sean P. Dineen (University of Texas MD Anderson Cancer Center)H-Index: 19
#2Richard E. Royal (University of Texas MD Anderson Cancer Center)H-Index: 34
Last. Keith Francis Fournier (University of Texas MD Anderson Cancer Center)H-Index: 13
view all 9 authors...
Background Complete cytoreduction with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) has been shown to improve survival in patients with low-grade mucinous adenocarcinoma (LGMA). However, incomplete cytoreduction exposes patients to significant morbidity without a similar survival benefit. Preoperative assessment of the ability to achieve CRS is therefore a critical step in selecting patients for CRS/HIPEC.
13 CitationsSource
#1Diane GoéréH-Index: 34
#2Amine SouadkaH-Index: 9
Last. Dominique EliasH-Index: 82
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Background The main prognostic factors after complete cytoreductive surgery (CCRS) of colorectal peritoneal carcinomatosis (PC) followed by intraperitoneal chemotherapy (IPC) are completeness of the resection and extent of the disease. This study aimed to determine a threshold value above which CCRS plus IPC may not offer survival benefit compared with systemic chemotherapy.
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Cited By2
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#1Michael K. Turgeon (Emory University)
#2Adriana C. Gamboa (Emory University)H-Index: 1
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BACKGROUND: Patient age is a significant factor in preoperative selection for major abdominal surgery. The association of age, tumor biology, and postoperative outcomes in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) remains ill-defined. METHODS: Retrospective analysis was performed for patients who underwent a CCR0/1 CRS/HIPEC from the US HIPEC Collaborative Database (2000-2017). Age was categorized into /= 65 years. Primary outcome was p...
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#1Radwan Diab (University of Texas MD Anderson Cancer Center)
#2Mayur Virarkar (University of Texas MD Anderson Cancer Center)
Last. Silvana de Castro Faria (University of Texas MD Anderson Cancer Center)H-Index: 17
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Mesenteries are extensions of the visceral and parietal peritoneum consisting of fat, vessels, nerves, and lymphatics. Mesenteric masses have a wide differential diagnosis with neoplastic, infectious, or inflammatory etiologies and can either be solid or cystic. Imaging features are critical for the diagnosis. We review the epidemiology, imaging spectrum, and differentiating features and treatment of mesenteric masses.
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