Prediction of 5-year survival in advanced-stage ovarian cancer patients based on computed tomography peritoneal carcinomatosis index

Abdom Radiol (NY). 2016 Nov;41(11):2196-2202. doi: 10.1007/s00261-016-0817-5.

Abstract

Objective: To evaluate whether the quantification of peritoneal metastases in advanced-stage ovarian cancer patients using the peritoneal carcinomatosis index, detected by CT (CT-PCI), correlates with the serum levels of tumor marker CA-125 and 5-year survival.

Methods: The CT-PCI was determined in 82 patients with stage III or stage IV ovarian cancer using the Sugarbaker classification prior to cytoreductive surgery. Linear regression analysis was used to correlate CT-PCI and CA-125 levels. Correlation of presurgical CT-PCI, optimal surgical cytoreduction, and 5-year survival was established using binary logistic regression analysis. A score for prediction of 5-year survival probability was established using multivariate backwards binary logistic regression.

Results: Presurgical CT-PCI correlates significantly with presurgical CA-125 serum levels (r = 0.487, P < 0.001). Multivariate binary logistic regression suggested significantly improved 5-year survival with lower CT-PCI and lower ECOG performance scores.

Conclusion: CT-PCI allows quantification of peritoneal disease in advanced-stage ovarian cancer patients, similar to CA-125. CT-PCI in combination with ECOG performance has the potential to help evaluate the 5-year survival probability.

Keywords: CA-125 antigen; Computed tomography; Neoadjuvant therapy; Ovarian cancer; Peritoneal disease; Prognosis.

MeSH terms

  • Aged
  • Biomarkers, Tumor / blood
  • CA-125 Antigen / blood
  • Contrast Media
  • Cytoreduction Surgical Procedures
  • Female
  • Humans
  • Iopamidol / analogs & derivatives
  • Middle Aged
  • Neoplasm Staging
  • Ovarian Neoplasms / diagnostic imaging*
  • Ovarian Neoplasms / mortality*
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / surgery
  • Peritoneal Neoplasms / diagnostic imaging*
  • Peritoneal Neoplasms / mortality*
  • Peritoneal Neoplasms / secondary*
  • Peritoneal Neoplasms / surgery
  • Prognosis
  • Survival Rate
  • Tomography, X-Ray Computed / methods*

Substances

  • Biomarkers, Tumor
  • CA-125 Antigen
  • Contrast Media
  • iomeprol
  • Iopamidol