PET/CT在复发性卵巢癌细胞减少手术选择中的价值。
The value of PET/CT for cytoreductive surgery selection in recurrent ovarian carcinoma.
发表日期:2023 Jan 20
作者:
Rafael Leite Nunes, Flávio Rodrigues Teixeira, Thiago Pereira Diniz, Carlos Chaves Faloppa, Henrique Mantoan, Alexandre Andre Balieiro Anastacio da Costa, Glauco Baiocchi
来源:
Journal of Gynecologic Oncology
摘要:
为评估正电子发射断层扫描/计算机断层扫描(PET/CT)在预测继发细胞减灭手术(SCS)后无残留病变(NRD)的价值,与MSK标准、iMODEL和AGO评分进行比较。我们分析了112例接受SCS的铂敏感性卵巢癌患者。我们排除未进行PET/CT检查、无足够数据和在SCS前接受化疗的患者。最终,包括69名患者。与NRD相关的变量是腹膜癌指数(OR=0.91;95%置信区间[CI]=0.83-0.99;p=0.044)、欧洲合作肿瘤组织学性能状态(ECOG)0级(OR=8.0;95% CI=1.34-47.5;p=0.022)和PET/CT检查发现≤2个病灶(OR=4.36;95% CI=1.07-17.7;p=0.039)。在≤2个病灶的患者中,有48人(92.3%)接受了完整的SCS。PET/CT检查对于NRD的敏感性、阳性预测值、阴性预测值和准确度分别为85.7%、92.3%、33.3%和81.2%。通过满足MSK标准、iMODEL和AGO评分可以在89.1%、88.1%和85.9%的患者中实现NRD。在预测NRD方面,MSK标准、iMODEL和AGO评分的准确度分别为87%、83.3%和77.3%。PET/CT检查结果与AGO评分和iMODEL相一致。将PET/CT添加到这些模型中可以增加NRD率(MSK+PET/CT、iMODEL+PET/CT和AGO+PET/CT分别为92.2%、91.8%和89.4%),但降低了它们的准确度。我们注意到,在PET/CT检查中有≤2个病灶的患者中,92.3%实现了NRD,准确度为81.2%。PET/CT检查不会增加MSK标准、iMODEL或AGO评分模型的准确度。© 2023年。亚洲妇科肿瘤学会、韩国妇科肿瘤学会和日本妇科肿瘤学会。
To evaluate the value of positron emission tomography/computed tomography (PET/CT) in predicting no residual disease (NRD) after secondary cytoreductive surgery (SCS) compared with MSK criteria, the iMODEL, and the AGO score.We analyzed 112 patients with platinum-sensitive ovarian carcinoma who underwent SCS. We excluded patients for whom PET/CT was not performed, those without sufficient data, and who received chemotherapy before SCS. Ultimately, 69 patients were included.Variables that correlated with NRD were peritoneal carcinomatosis index (odds ratio [OR]=0.91; 95% confidence interval [CI]=0.83-0.99; p=0.044), European Cooperative Oncology Group Performance Status (ECOG) 0 (OR=8.0; 95% CI=1.34-47.5; p=0.022), and ≤2 lesions by PET/CT (OR=4.36; 95% CI=1.07-17.7; p=0.039). Of the patients with ≤2 lesions by PET/CT, 48 (92.3%) underwent complete SCS. The sensitivity, positive predictive value, negative predictive value, and accuracy of PET/CT for NRD were 85.7%, 92.3%, 33.3%, and 81.2%, respectively. NRD was achieved after fulfilling the MSK criteria, iMODEL and AGO Score in 89.1%, 88.1% and 85.9%, respectively. The accuracy of the MSK criteria, iMODEL, and AGO score in predicting NRD was 87%, 83.3%, and 77.3%, respectively. The PET/CT findings agreed well with the AGO score and iMODEL. The addition of PET/CT to these models increased the NRD rates (92.2%, 91.8%, and 89.4% for MSK+PET/CT, iMODEL+PET/CT, and AGO+PET/CT, respectively), but lowered their accuracy.We observed NRD in 92.3% of patients with ≤2 lesions by PET/CT, with an accuracy of 81.2%. PET/CT did not increase the accuracy of the MSK criteria, iMODEL, or AGO score models.© 2023. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.