Department of Surgery and Oncology, University of Calgary, Calgary, Alberta, Canada.
Department of Surgery and Oncology, University of Calgary, Calgary, Alberta, Canada.
Am J Surg. 2014 May;207(5):760-4; discussion 764-5. doi: 10.1016/j.amjsurg.2013.12.024. Epub 2014 Mar 12.
Obtaining a complete cytoreduction in patients with peritoneal carcinomatosis (PC) is one of the most significant prognostic variables for long-term survival. This study explored features on preoperative computed tomography (CT) to predict unresectability.
A retrospective case-control study was conducted of 15 patients with unresectable PC and 15 patients with completely resected PC matched by intraoperative peritoneal cancer index (PCI) and pathology type. Two surgical oncologists blindly analyzed all abdominopelvic CT scans.
PCI estimated on imaging was not higher in unresectable patients (P = .851) and significantly underestimated intraoperative PCI measurement (P = .003). No single concerning feature was associated with unresectability. However, patients with 2 or more concerning features were more likely to be unresectable (87.5% vs 36.4%, P = .035).
Two or more concerning CT imaging features appear to be associated with a higher risk of unresectability in patients with PC. However, no specific imaging feature should exclude a patient from an attempted cytoreduction.
在患有腹膜癌病（PC）的患者中获得完全的细胞减灭术是长期生存的最重要预后变量之一。本研究探讨了术前计算机断层扫描（CT）的特征，以预测不可切除性。
对 15 例不可切除性 PC 患者和 15 例术中腹膜癌指数（PCI）和病理类型相匹配的完全切除性 PC 患者进行回顾性病例对照研究。两名外科肿瘤学家对所有腹盆腔 CT 扫描进行了盲法分析。
不可切除性患者的影像学评估 PCI 并不高（P =.851），且明显低估了术中 PCI 测量值（P =.003）。没有一个单一的可疑特征与不可切除性相关。然而，有 2 个或更多可疑特征的患者更有可能无法切除（87.5%比 36.4%，P =.035）。
在患有 PC 的患者中，2 个或更多可疑 CT 影像学特征似乎与更高的不可切除性风险相关。然而，没有特定的影像学特征可以排除患者接受细胞减灭术的尝试。
