Metabolic active peritoneal sites affect tumor debulking in ovarian and peritoneal cancers

Abstract Rationale and objectives To evaluate the impact of metabolic parameters in the peritoneal cavity on the likelihood of achieving complete tumor debulking in patients with ovarian and peritoneal cancers. Materials and methods Forty-nine patients with ovarian and peritoneal cancers were includ...

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Main Authors: Tung Tung Tsoi, Keith W. H. Chiu, M. Y. Chu, Hextan Y. S. Ngan, Elaine Y. P. Lee
Format: Article
Language:English
Published: BMC 2020-05-01
Series:Journal of Ovarian Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13048-020-00662-3
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author Tung Tung Tsoi
Keith W. H. Chiu
M. Y. Chu
Hextan Y. S. Ngan
Elaine Y. P. Lee
author_facet Tung Tung Tsoi
Keith W. H. Chiu
M. Y. Chu
Hextan Y. S. Ngan
Elaine Y. P. Lee
author_sort Tung Tung Tsoi
collection DOAJ
description Abstract Rationale and objectives To evaluate the impact of metabolic parameters in the peritoneal cavity on the likelihood of achieving complete tumor debulking in patients with ovarian and peritoneal cancers. Materials and methods Forty-nine patients with ovarian and peritoneal cancers were included, who underwent pre-operative 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT). The immediate surgical outcome was dichotomized into complete and incomplete tumor debulking. 18F-FDG PET/CT was qualitatively and quantitatively assessed by scrutinizing 15 anatomical sites for the presence of peritoneal carcinomatosis (PC). Patient-based and site-based diagnostic characteristics were described. Metabolic parameters (SUVmax, metabolic tumor volume and total lesion glycolysis) and the number of 18F-FDG avid peritoneal sites were evaluated between the two groups. Receiver operating curve (ROC) analysis was performed to determine the optimal cut-off value in predicting incomplete tumor debulking. Results Twenty-seven out of the 49 patients had PC and 11 had incomplete debulking. Patient-based and site-based accuracies for detection of PC were 87.8 and 97.6%, respectively. The number of 18F-FDG avid peritoneal sites was significantly different between complete and incomplete debulking groups (0.6 ± 0.8 versus 2.3 ± 1.7 sites respectively, p = 0.001), and the only independent significant risk factor among other metabolic parameters tested (odd ratio = 2.983, 95% CI 1.104–8.062) for incomplete tumor debulking with an optimal cut-off value of ≥4 (AUC = 0.816). Conclusion The number of 18F-FDG avid peritoneal sites increased the risk of incomplete tumor debulking after surgery and potentially useful in assisting treatment stratification in patients with ovarian and peritoneal cancers.
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spelling doaj.art-2eefc4663c6a4b4389cc067ac55b8ee62023-01-02T14:07:11ZengBMCJournal of Ovarian Research1757-22152020-05-011311910.1186/s13048-020-00662-3Metabolic active peritoneal sites affect tumor debulking in ovarian and peritoneal cancersTung Tung Tsoi0Keith W. H. Chiu1M. Y. Chu2Hextan Y. S. Ngan3Elaine Y. P. Lee4Department of Diagnostic Radiology, Queen Mary Hospital, The University of Hong KongDepartment of Diagnostic Radiology, Queen Mary Hospital, The University of Hong KongDepartment of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong KongDepartment of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong KongDepartment of Diagnostic Radiology, Queen Mary Hospital, The University of Hong KongAbstract Rationale and objectives To evaluate the impact of metabolic parameters in the peritoneal cavity on the likelihood of achieving complete tumor debulking in patients with ovarian and peritoneal cancers. Materials and methods Forty-nine patients with ovarian and peritoneal cancers were included, who underwent pre-operative 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT). The immediate surgical outcome was dichotomized into complete and incomplete tumor debulking. 18F-FDG PET/CT was qualitatively and quantitatively assessed by scrutinizing 15 anatomical sites for the presence of peritoneal carcinomatosis (PC). Patient-based and site-based diagnostic characteristics were described. Metabolic parameters (SUVmax, metabolic tumor volume and total lesion glycolysis) and the number of 18F-FDG avid peritoneal sites were evaluated between the two groups. Receiver operating curve (ROC) analysis was performed to determine the optimal cut-off value in predicting incomplete tumor debulking. Results Twenty-seven out of the 49 patients had PC and 11 had incomplete debulking. Patient-based and site-based accuracies for detection of PC were 87.8 and 97.6%, respectively. The number of 18F-FDG avid peritoneal sites was significantly different between complete and incomplete debulking groups (0.6 ± 0.8 versus 2.3 ± 1.7 sites respectively, p = 0.001), and the only independent significant risk factor among other metabolic parameters tested (odd ratio = 2.983, 95% CI 1.104–8.062) for incomplete tumor debulking with an optimal cut-off value of ≥4 (AUC = 0.816). Conclusion The number of 18F-FDG avid peritoneal sites increased the risk of incomplete tumor debulking after surgery and potentially useful in assisting treatment stratification in patients with ovarian and peritoneal cancers.http://link.springer.com/article/10.1186/s13048-020-00662-318F-FDG PET/CTOvarian and peritoneal cancersTumor debulkingPeritoneal carcinomatosis
spellingShingle Tung Tung Tsoi
Keith W. H. Chiu
M. Y. Chu
Hextan Y. S. Ngan
Elaine Y. P. Lee
Metabolic active peritoneal sites affect tumor debulking in ovarian and peritoneal cancers
Journal of Ovarian Research
18F-FDG PET/CT
Ovarian and peritoneal cancers
Tumor debulking
Peritoneal carcinomatosis
title Metabolic active peritoneal sites affect tumor debulking in ovarian and peritoneal cancers
title_full Metabolic active peritoneal sites affect tumor debulking in ovarian and peritoneal cancers
title_fullStr Metabolic active peritoneal sites affect tumor debulking in ovarian and peritoneal cancers
title_full_unstemmed Metabolic active peritoneal sites affect tumor debulking in ovarian and peritoneal cancers
title_short Metabolic active peritoneal sites affect tumor debulking in ovarian and peritoneal cancers
title_sort metabolic active peritoneal sites affect tumor debulking in ovarian and peritoneal cancers
topic 18F-FDG PET/CT
Ovarian and peritoneal cancers
Tumor debulking
Peritoneal carcinomatosis
url http://link.springer.com/article/10.1186/s13048-020-00662-3
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AT hextanysngan metabolicactiveperitonealsitesaffecttumordebulkinginovarianandperitonealcancers
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