MacKintosh M L, Rahim R, Rajashanker B, Swindell R, Kirmani B H, Hunt J, Brockbank E, Barton D P J, Clayton R D
Department of Gynaecological Oncology, Central Manchester Foundation Trust , Manchester , UK.
J Obstet Gynaecol. 2014 Jul;34(5):424-8. doi: 10.3109/01443615.2014.899330. Epub 2014 Apr 11.
Our aim was to design and validate a model of CT findings that predict suboptimal cytoreduction in primary surgery (PS) for Stage III-IV epithelial ovarian cancer (EOC). We performed a retrospective review of preoperative CT scans of patients undergoing PS for EOC in a cancer centre in London, UK, between November 1995 and October 2003 (n = 91). Radiological features predictive of suboptimal cytoreduction were identified and the model tested in a second cohort undergoing PS in Manchester, June 2005 - March 2007 (n = 35). In the London cohort, liver surface disease and infrarenal para-aortic lymph node involvement predicted suboptimal cytoreduction with 80% accuracy. Accuracy of these predictors dropped to 63% when applied to the Manchester cohort. We concluded that CT prediction of suboptimal cytoreduction is unreliable and may not be reproducible. In the absence of favourable data from larger, prospective trials, it should not be used to guide management.
我们的目标是设计并验证一个基于CT检查结果的模型，用于预测Ⅲ-Ⅳ期上皮性卵巢癌（EOC）初次手术（PS）时减瘤效果欠佳的情况。我们对1995年11月至2003年10月期间在英国伦敦一家癌症中心接受EOC初次手术的患者术前CT扫描进行了回顾性研究（n = 91）。确定了预测减瘤效果欠佳的放射学特征，并在2005年6月至2007年3月在曼彻斯特接受初次手术的第二个队列（n = 35）中对该模型进行了测试。在伦敦队列中，肝表面病变和肾下主动脉旁淋巴结受累预测减瘤效果欠佳的准确率为80%。当应用于曼彻斯特队列时，这些预测指标的准确率降至63%。我们得出结论，CT预测减瘤效果欠佳并不可靠，可能无法重复。在缺乏来自更大规模前瞻性试验的有利数据的情况下，不应将其用于指导治疗。
