title: Is postoperative computed tomography evaluation a prognostic indicator in patients with optimally debulked advanced ovarian cancer?
abstract: OBJECTIVE
  To compare the surgeon's intraoperative assessment of residual tumor (RT) disease with that identified on postoperative computed tomography (CT) in patients undergoing optimal primary surgical cytoreduction (RT <1 cm) and to identify the prognostic significance of postoperative CT scan of RT.
  
  
  METHODS
  Patients with FIGO stage III-IV ovarian cancer treated at the Gynecologic Oncology Unit of the National Cancer Institute between November 2011 and March 2013, who underwent optimal primary cytoreduction and were entered in prospective controlled clinical trials requiring a baseline postoperative CT evaluation within 30 days, were enrolled. All CT scans were reviewed by a dedicated radiologist to evaluate RT. Median follow-up was 16 months.
  
  
  RESULTS
  64 out of 160 patients met the eligibility criteria. RT = 0, 0.1 < RT < 0.5 cm, and 0.6 < RT < 1 cm was reported in 53 (82.8%), 9 (14.1%) and 2 (3.1%) cases, respectively. Postoperative CT disagreed with RT in 13 out of 64 (20.3%) cases. Progression-free survival (PFS) of patients with a positive and negative postoperative CT scan of RT was 5 months (95% CI 1-15 months) and 28 months (95% CI 2-46 months), respectively (p < 0.0001). Evidence of the disease using postoperative CT was an independent prognostic factor in multivariate analysis (HR = 8.87, 95% CI = 3.23-24.31, p < 0.0001).
  
  
  CONCLUSIONS
  Evidence of the disease using postoperative CT was associated with a significant decrease in PFS in patients who underwent optimal primary cytoreduction. RT status as evaluated with early postoperative CT may have an important role in prognostic assessment.
authors.affiliation: Gynecologic Oncology Unit, Fondazione IRCCS National Cancer Institute, Milan, Italy.
authors.forename: Domenica
authors.initials: D
authors.lastname: Lorusso
authors.forename: Italo
authors.initials: I
authors.lastname: Sarno
authors.forename: Violante
authors.initials: V
authors.lastname: Di Donato
authors.forename: Antonella
authors.initials: A
authors.lastname: Palazzo
authors.forename: Elena
authors.initials: E
authors.lastname: Torrisi
authors.forename: Laura
authors.initials: L
authors.lastname: Pala
authors.forename: Alfonso
authors.initials: A
authors.lastname: Marchiano
authors.forename: Francesco
authors.initials: F
authors.lastname: Raspagliesi
mesh_terms: D000328:Adult; D000368:Aged; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D018365:Neoplasm, Residual; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D014057:Tomography, X-Ray Computed / Q000379:methods*