Prospective study of the correlation between postoperative computed tomography scan and primary surgeon assessment in patients with advanced ovarian, tubal, and peritoneal carcinoma reported to have undergone primary surgical cytoreduction to residual disease 1 cm or less.
OBJECTIVE
To compare surgeons' operative assessments of residual disease (RD) to those identified on postoperative computed tomography (CT) scans in patients with advanced ovarian carcinoma reported to have undergone optimal primary cytoreduction.


METHODS
All patients at one of two institutions, who were scheduled to have primary surgery for presumed advanced ovarian cancer, were asked to consent to a postoperative CT scan if cytoreduction to < or = 1 cm RD was reported. CT scan findings were graded using a qualitative analysis scale from 1 (normal) to 5 (definitely malignant).


RESULTS
From January 2001 to September 2006, 285 patients were enrolled. A total of 78 patients met eligibility criteria and had postoperative CT scans. In 41 cases (52%), postoperative scan findings correlated with the surgical report of no RD more than 1 cm, and in seven cases (9%), the CT findings were indeterminate. In 10 cases (13%), more than 1 cm RD was noted by the radiologist as probably malignant, and in 20 cases (26%), definitely malignant. In these 30 cases, the radiologically reported median largest residual mass was 1.9 cm (range, 1.1 to 5.1), with RD more than 1 cm reported most commonly in the right upper quadrant (15 patients [50%]) and central abdomen (nine patients [30%]).


CONCLUSIONS
There was only a 52% correlation between surgeons' assessments and postoperative CT scan evaluations of RD in patients reported to have undergone optimal cytoreduction. Further study is required to determine whether this lack of correlation is due to rapid interval tumor regrowth, RD underestimated by the surgeons, and/or overestimated by the radiologists; and to determine the clinical implications of these discrepancies.
Chi
Dennis S
DS
Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. gynbreast@mskcc.org or chid@mskcc.org
Ramirez
Pedro T
PT
Teitcher
Jerrold B
JB
Mironov
Svetlana
S
Sarasohn
Debra M
DM
Iyer
Revathy B
RB
Eisenhauer
Eric L
EL
Abu-Rustum
Nadeem R
NR
Sonoda
Yukio
Y
Levine
Douglas A
DA
Brown
Carol L
CL
Aghajanian
Carol
C
Gershenson
David M
DM
Hoskins
William J
WJ
Hricak
Hedvig
H
Barakat
Richard R
RR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005185:Fallopian Tube Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000175:diagnosis*; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D010808:Physical Examination; D011182:Postoperative Care; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed