Table 8 Summary of the studies analysing the performance of computed tomography (CT) scan in the prediction of optimal cytoreduction in ovarian cancer

From: Role of CT scan-based and clinical evaluation in the preoperative prediction of optimal cytoreduction in advanced ovarian cancer: a prospective trial

Author, year	Time	Type of study	No.	% Stage III/IV	No. of surgeons	Optimal RT (cm)	% Optimal debulking	CT scan slice thickness	CT-based factors	CT score	Cutoff score	NPV	PPV
Nelson et al (1993)	December 1985	R	42	81	4	<2	69	NS	8^a	No	—	95.8	66.7
	May 1991											93.8^b	66.7^b
Meyer et al (1995)	1989	R	28	57	3	⩽2	57	10 mm	6^c	Yes^c	⩾3	76.2	100
	1992											54.5^b	100^b
Forstner et al (1995)	June 1990 May 1994	P	43	72	NA	⩽2	86	7–10 mm	9^d	No	—	92.5	100
Bristow et al (2000)	July 1997 July 1999	R	41	100	9	⩽1	49	5 mm	13^e	Yes	⩾4	100	87.5
Byrom et al (2002)	January 1998 August 1999	R	77^f	55	NA	0	36^g	8–10 mm	2^h	Yesⁱ	5ⁱ	90	95
Dowdy et al (2004)	1996 2001	R	87	100	NA	<1	71	5–10 mm	3^j	No	—	81^j	79^j
Qayyum et al (2005)	NA	R	105	77	3	⩽2	80	7–10 mm	15^k	No	—	96	94
Axtell et al (2007)	1999 2005	R	67	100	NA	⩽1	78	5–10 mm	14^l	No	—	98	46

Abbreviations: NA=not applicable; NS=not specified; P=prospective; R=retrospective.
^aCT-assessed criteria for unresectability were as follows: (1) the attachment of omentum to spleen; (2) the presence of >2 cm disease located at any one or more of the following sites: mesentery, gallbladder fossa, pericardiac lymph nodes, pulmonary or pleural nodules, liver surface or parenchyma, suprarenal para-aortic nodes, diaphragm.
^bIn stage III/IV cases.
^cScores from 0 to 2 were assigned for the presence of disease at the following sites: omentum, liver, para-aortic nodes, diaphragm and lung base, small bowel mesentery, amount of ascites, according to the diameter and extension of the disease.
^dThe following parameters were used: >2 cm disease located at peritoneum (thickening or implant), at small or larger bowel mesentery, omentum, pelvis (sidewall, parametria, hydroureter), infrarenal or suprarenal nodes, liver (surface or parenchyma), porta hepatis/gallbladder, diaphragm/lung base, inguinal canal, ascites.
^eThe following parameters were used: >2 cm disease located at mesentery, porta hepatis, lesser sac, intersegmental fissure, dome of the liver, gastrosplenic ligament, diaphragm, nodes at and above the celiac axis, presacral extraperitoneal disease.
^fIncluding also benign (n=26), and early-stage cancer (n=23).
^g36% in the whole series (52 out of 77), and 10.7% in stage III–IV cancer (3 out of 28).
^hOnly CT-assessed omental cake and presence of mesenteric disease were independent predictors of unresectability;
ⁱThe score also included age and Ca125 levels.
^jMultivariate analysis identified three variables (diffuse peritoneal carcinomatosis, ascites, and diaphragm involvement) as the only significant predictors of unresectability; NPV and PPV refer to the model including these three parameters.
^kCT-assessed criteria for unresectability were as follows: presence of >2 cm disease located at any one or more of 14 critical sites: porta hepatis, intersegmental fissure, gallbladder fossa, subphrenic space, gastrohepatic and gastrosplenic ligaments, lesser sac, small bowel mesentery, dome of the liver surface, suprarenal para-aortic nodes, celiac axis supradiaphragmatic involvement, liver, abdominal wall invasion.
^lMultivariate analysis including 14 CT-based variables and four clinical parameters identified only two variables (tumour>2 cm at the large bowel mesentery and diaphragm) as the only significant predictors of unresectability; NPV and PPV refer to the model including these two parameters.

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Table 8 Summary of the studies analysing the performance of computed tomography (CT) scan in the prediction of optimal cytoreduction in ovarian cancer

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