Proposed radiological criteria for pre‐operative determination of resectability in peritoneal‐based malignancies

Tan, Grace Hwei Ching; Kwek, Jin Wei; Hosseini, Reza; Chanyaputhipong, Jendana; Tham, Chee Kian; Soo, Khee Chee; Teo, Melissa Ching Ching

doi:10.1111/1754-9485.12456

Cited by 8 publications

(5 citation statements)

References 19 publications

(43 reference statements)

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“…We compiled a list of unfavourable sites based on the experience of our surgeons who see involvement at these sites lead to increased surgical complexity or inability to achieve complete cytoreduction. This was similar to radiological criteria proposed by Tan et al 24 for resectability of peritoneal malignancy in general, the exception being the omental cake, which we did not include in our list as an unfavourable finding, since the greater omentum BJR Full paper: Peritoneal mesothelioma: predictors of complete cytoreduction can be easily removed at surgery. We also quantified the volume of upper abdominal disease by adding the rPCI scores of the upper abdominal sites (site1 + site2 + site3).…”

Section: Malignant Mesotheliomasupporting

confidence: 68%

Radiological predictors of complete cytoreduction in 59 patients with peritoneal mesothelioma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at a UK referral centre

Chandramohan

Thrower

Shah

et al. 2017

The British Journal of Radiology

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Involvement of key anatomical sites such as small bowel serosa and large volume upper abdominal disease reduced the likelihood of achieving complete cytoreduction in patients with malignant peritoneal mesothelioma. Advances in knowledge: Demonstration of small bowel disease and large volume upper abdominal disease on imaging in patients with malignant peritoneal mesothelioma can be used to identify patients who may not benefit from cytoreductive surgery.

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Section: Malignant Mesotheliomasupporting

confidence: 68%

Radiological predictors of complete cytoreduction in 59 patients with peritoneal mesothelioma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at a UK referral centre

Chandramohan

Thrower

Shah

et al. 2017

The British Journal of Radiology

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“…Computed tomography prognostic risk factors for unresectable disease (CT risks) were defined according to the previous study as follows [ 14 ]: the presence of small bowel serosal or mesenteric disease, gross ascites, presence of a peritoneal lesion measuring > 5 cm, omental cake, small or large bowel obstruction, peri-hepatic nodules, ureteric obstruction, and biliary obstruction. The surgeon routinely assessed the peritoneal cancer index (PCI) score at the beginning, and the completeness of cytoreduction (CCR) degree at the end of CRS-HIPEC procedure as Sugarbaker described [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer with Peritoneal Carcinomatosis: Additional Information Helps to Optimize Patient Selection before Surgery

Hung

Hsu

Lee

et al. 2023

Cancers

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(1) Background: The prognosis of gastric cancer-associated peritoneal carcinomatosis (GCPC) is poor, with a median survival time of less than six months, and current systemic chemotherapy, including targeted therapy, is ineffective. Despite growing evidence that cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for GCPC improves overall survival (OS), optimal patient selection remains unclear. We aimed to evaluate preoperative clinical factors and identify indicative factors for predicting postoperative OS in patients with GCPC undergoing CRS-HIPEC. (2) Methods: We retrospectively reviewed 44 consecutive patients with GCPC who underwent CRS-HIPEC between May 2015 and May 2021. Data on demographics and radiologic assessment were collected and analyzed. (3) Results: Elevated preoperative serum neutrophil-to-lymphocyte ratio > 4.4 (p = 0.003, HR = 3.70, 95% CI = 1.55–8.79) and number of computed tomography risks > 2 (p = 0.005, HR = 3.26, 95% CI = 1.33–7.98) were independently indicative of OS post-surgery. A strong correlation was observed between intraoperative peritoneal cancer index score and number of computed tomography risks (r = 0.534, p < 0.0001). Two patients after CRS-HIPEC ultimately achieved disease-free survival for more than 50 months. (4) Conclusions: Our experience optimizes GCPC patients’ selection for CRS-HIPEC, may help to improve outcomes in the corresponding population, and prevent futile surgery in inappropriate patients.

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“…The presence of disease in certain locations is associated with a worse prognosis due to the reduced likelihood of achieving optimal CRS. These locations are the small bowel and/or its mesentery, the porta hepatis and hepatoduodenal ligament, ureteric encasement, and biliary obstruction [ 26 ]. Such observations led to the study and development of radiologic scores to predict the resectability of the disease.…”

Section: Review Sectionsmentioning

confidence: 99%

Appendiceal Mucinous Neoplasms: From Clinic to Pathology and Prognosis

González-Bayón

Román

Lominchar

2023

Cancers

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Appendiceal mucinous neoplasms have been classified differently over time causing confusion when comparing results between working groups in this field and establishing a prognosis of the disease. A historical perspective of the different classification systems of these tumors is essential for the understanding of the evolution of concepts and histopathological definitions that have led up to the present moment. We carried out a systematic review of the pathological classifications of appendiceal mucinous tumors and how they have included the new criteria resulting from clinical and pathological research. The latest classifications by PSOGI and AJCC 8th edition Cancer Staging have made a great effort to incorporate the new pathological descriptions and develop prognostic groups. The introduction of these new classification systems has posed the challenge of verifying how they adapt to our casuistry and which one defines best the prognosis of our patients. We reclassified our series of patients treated for mucinous appendiceal tumors with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy following the PSOGI and the AJCC 8th edition criteria and concluded that both classifications correspond well with the OS and DFS of these patients, with some advantage relative to the PSOGI classification due to a better histopathological description of the different groups.

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Proposed radiological criteria for pre‐operative determination of resectability in peritoneal‐based malignancies

Abstract: With our proposed criteria, and scoring system, the selection of patients for CRS and HIPEC can be improved, and unnecessary exploratory operations avoided.

Cited by 8 publications

References 19 publications

Radiological predictors of complete cytoreduction in 59 patients with peritoneal mesothelioma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at a UK referral centre

Radiological predictors of complete cytoreduction in 59 patients with peritoneal mesothelioma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at a UK referral centre

Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer with Peritoneal Carcinomatosis: Additional Information Helps to Optimize Patient Selection before Surgery

Appendiceal Mucinous Neoplasms: From Clinic to Pathology and Prognosis

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