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      The value of PET/CT for cytoreductive surgery selection in recurrent ovarian carcinoma

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      https://www.riss.kr/link?id=A108573253

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      다국어 초록 (Multilingual Abstract)

      Objective: 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.
      Methods: 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.
      Results: 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.
      Conclusion: 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.
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      Objective: 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. Methods: We an...

      Objective: 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.
      Methods: 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.
      Results: 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.
      Conclusion: 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.

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      참고문헌 (Reference)

      1 Cho SM, "Usefulness of FDG PET for assessment of early recurrent epithelial ovarian cancer" 179 : 391-395, 2002

      2 Simcock B, "The impact of PET/CT in the management of recurrent ovarian cancer" 103 : 271-276, 2006

      3 Fulham MJ, "The impact of PET-CT in suspected recurrent ovarian cancer : a prospective multi-centre study as part of the Australian PET Data Collection Project" 112 : 462-468, 2009

      4 Harter P, "Surgery in recurrent ovarian cancer : the Arbeitsgemeinschaft Gynaekologische Onkologie(AGO)DESKTOP OVAR trial" 13 : 1702-1710, 2006

      5 Coleman RL, "Secondary surgical cytoreduction for recurrent ovarian cancer" 381 : 1929-1939, 2019

      6 Baek MH, "Secondary cytoreductive surgery in platinum-sensitive recurrent ovarian cancer : a meta-analysis" 40 : 1659-1670, 2022

      7 Shi T, "Secondary cytoreduction followed by chemotherapy versus chemotherapy alone in platinum-sensitive relapsed ovarian cancer(SOC-1) : a multicentre, openlabel, randomised, phase 3 trial" 22 : 439-449, 2021

      8 Son H, "Role of FDG PET/CT in staging of recurrent ovarian cancer" 31 : 569-583, 2011

      9 Fagotti A, "Randomized trial of primary debulking surgery versus neoadjuvant chemotherapy for advanced epithelial ovarian cancer(SCORPIONNCT01461850)" 30 : 1657-1664, 2020

      10 Harter P, "Randomized trial of cytoreductive surgery for relapsed ovarian cancer" 385 : 2123-2131, 2021

      1 Cho SM, "Usefulness of FDG PET for assessment of early recurrent epithelial ovarian cancer" 179 : 391-395, 2002

      2 Simcock B, "The impact of PET/CT in the management of recurrent ovarian cancer" 103 : 271-276, 2006

      3 Fulham MJ, "The impact of PET-CT in suspected recurrent ovarian cancer : a prospective multi-centre study as part of the Australian PET Data Collection Project" 112 : 462-468, 2009

      4 Harter P, "Surgery in recurrent ovarian cancer : the Arbeitsgemeinschaft Gynaekologische Onkologie(AGO)DESKTOP OVAR trial" 13 : 1702-1710, 2006

      5 Coleman RL, "Secondary surgical cytoreduction for recurrent ovarian cancer" 381 : 1929-1939, 2019

      6 Baek MH, "Secondary cytoreductive surgery in platinum-sensitive recurrent ovarian cancer : a meta-analysis" 40 : 1659-1670, 2022

      7 Shi T, "Secondary cytoreduction followed by chemotherapy versus chemotherapy alone in platinum-sensitive relapsed ovarian cancer(SOC-1) : a multicentre, openlabel, randomised, phase 3 trial" 22 : 439-449, 2021

      8 Son H, "Role of FDG PET/CT in staging of recurrent ovarian cancer" 31 : 569-583, 2011

      9 Fagotti A, "Randomized trial of primary debulking surgery versus neoadjuvant chemotherapy for advanced epithelial ovarian cancer(SCORPIONNCT01461850)" 30 : 1657-1664, 2020

      10 Harter P, "Randomized trial of cytoreductive surgery for relapsed ovarian cancer" 385 : 2123-2131, 2021

      11 Harter P, "Prospective validation study of a predictive score for operability of recurrent ovarian cancer : the Multicenter Intergroup Study DESKTOP II. A project of the AGO Kommission OVAR, AGO Study Group, NOGGO, AGO-Austria, and MITO" 21 : 289-295, 2011

      12 Minaguchi T, "Proposal for selection criteria of secondary cytoreductive surgery in recurrent epithelial ovarian, tubal, and peritoneal cancers" 21 : 573-579, 2016

      13 Kehoe S, "Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer(CHORUS) : an open-label, randomised, controlled, non-inferiority trial" 386 : 249-257, 2015

      14 Kitajima K, "Present and future of FDG-PET/CT in ovarian cancer" 25 : 155-164, 2011

      15 Zang RY, "Predictors of survival in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery based on the pooled analysis of an international collaborative cohort" 105 : 890-896, 2011

      16 Torizuka T, "Ovarian cancer recurrence : role of whole-body positron emission tomography using 2-[fluorine-18]-fluoro-2-deoxy-D-glucose" 29 : 797-803, 2002

      17 Vergote I, "Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer" 363 : 943-953, 2010

      18 Sironi S, "Integrated FDG PET/CT in patients with persistent ovarian cancer : correlation with histologic findings" 233 : 433-440, 2004

      19 Soussan M, "Impact of FDG PET-CT imaging on the decision making in the biologic suspicion of ovarian carcinoma recurrence" 108 : 160-165, 2008

      20 Estati FL, "Impact of BRCA1/2mutations on the efficacy of secondary cytoreductive surgery" 28 : 3637-3645, 2021

      21 Chi DS, "Guidelines and selection criteria for secondary cytoreductive surgery in patients with recurrent, platinum-sensitive epithelial ovarian carcinoma" 106 : 1933-1939, 2006

      22 Sung H, "Global cancer statistics 2020 : GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries" 71 : 209-249, 2021

      23 Colombo N, "ESMO-ESGO consensus conference recommendations on ovarian cancer : pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease" 30 : 672-705, 2019

      24 Xu B, "Diagnostic value of positron emission tomography(PET)and PET/computed tomography in recurrent/metastatic ovarian cancer : a meta-analysis" 43 : 378-386, 2017

      25 Cecere SC, "Cytoreductive surgery followed by chemotherapy and olaparib maintenance in BRCA 1/2 mutated recurrent ovarian cancer : a retrospective MITO group study" 31 : 1031-1036, 2021

      26 Choi HJ, "Comparison of the accuracy of magnetic resonance imaging and positron emission tomography/computed tomography in the presurgical detection of lymph node metastases in patients with uterine cervical carcinoma : a prospective study" 106 : 914-922, 2006

      27 Onda T, "Comparison of survival between primary debulking surgery and neoadjuvant chemotherapy for stage III/IV ovarian, tubal and peritoneal cancers in phase III randomised trial" 130 : 114-125, 2020

      28 Thrall MM, "Clinical use of combined positron emission tomography and computed tomography(FDG-PET/CT)in recurrent ovarian cancer" 105 : 17-22, 2007

      29 Gu P, "CA 125, PET alone, PET-CT, CT and MRI in diagnosing recurrent ovarian carcinoma : a systematic review and meta-analysis" 71 : 164-174, 2009

      30 Giorgio Bogani ; Diego Rossetti ; Antonino Ditto ; Fabio Martinelli ; Valentina Chiappa ; Lavinia Mosca ; Umberto Leone Roberti Maggiore ; Stefano Ferla ; Domenica Lorusso ; Francesco Raspagliesi, "Artificial intelligence weights the importance of factors predicting complete cytoreduction at secondary cytoreductive surgery for recurrent ovarian cancer" 대한부인종양학회 29 (29): 1-8, 2018

      31 Salani R, "An update on post-treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies : Society of Gynecologic Oncology(SGO)recommendations" 146 : 3-10, 2017

      32 Muallem MZ, "AGO score as a predictor of surgical outcome at secondary cytoreduction in patients with ovarian cancer" 35 : 3423-3429, 2015

      33 Giorgio Bogani ; Elena Tagliabue ; Mauro Signorelli ; Antonino Ditto ; Fabio Martinelli ; Valentina Chiappa ; Lavinia Mosca ; Ilaria Sabatucci ; Umberto Leone Roberti Maggiore ; Domenica Lorusso ; Francesco Raspagliesi, "A score system for complete cytoreduction in selected recurrent ovarian cancer patients undergoing secondary cytoreductive surgery: predictors- and nomogram-based analyses" 대한부인종양학회 29 (29): 1-11, 2018

      34 Tian WJ, "A risk model for secondary cytoreductive surgery in recurrent ovarian cancer : an evidence-based proposal for patient selection" 19 : 597-604, 2012

      35 Angioli R, "A predictive score for secondary cytoreductive surgery in recurrent ovarian cancer(SeC-Score) : a single-centre, controlled study for preoperative patient selection" 22 : 4217-4223, 2015

      36 Aletti GD, "A new frontier for quality of care in gynecologic oncology surgery : multi-institutional assessment of short-term outcomes for ovarian cancer using a risk-adjusted model" 107 : 99-106, 2007

      37 Cowan RA, "A comparative analysis of prediction models for complete gross resection in secondary cytoreductive surgery for ovarian cancer" 145 : 230-235, 2017

      38 Zimny M, "2-[Fluorine-18]-fluoro-2-deoxyd-glucose positron emission tomography in the diagnosis of recurrent ovarian cancer" 83 : 310-315, 2001

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