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Article: The role of CT in predicting the surgical feasibility of exenteration in recurrent carcinoma of the cervix

TitleThe role of CT in predicting the surgical feasibility of exenteration in recurrent carcinoma of the cervix
Authors
Keywordsascites
cervical cancer
CT
exenteration
Issue Date1996
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.ijgc.net/
Citation
International Journal Of Gynecological Cancer, 1996, v. 6 n. 3, p. 231-234 How to Cite?
AbstractIn women with recurrent cervical cancer, there is a 52% 5-year survival rate when exenteration of the centrally placed tumor is performed. If not exenterated, the 2-year survival rate is less than 2%. The purpose of this study is to ascertain whether CT can predict inoperability reliably leading to a reduction in operations which do not have a curative outcome. The records of patients with recurrence of cervical cancer who underwent laparotomies for exenteration over the last 10 years under the care of one surgeon were reviewed. The CT scans were retrospectively assessed by two radiologists without knowledge of the subsequent outcome of the laparotomy. CT scans on 31 patients were reviewed, 21 of whom underwent a radical surgical procedure. Using CT criteria, 9 cases were felt to be operable with a curative intent and the remaining 22 cases were deemed to be inoperable. The sensitivity of CT prediction of inoperability is 93% (95%Cl:66-100%) and the specificity is 47% (95%Cl:23-72%). In three cases ascites was the only abnormal finding other than the central pelvic mass and in all of these cases a radical procedure with clear resection margins was possible. When the group with ascites alone was not considered to have peritoneal disease underlying the ascites, the sensitivity of CT prediction of inoperability is 93% (95%Cl:66-100%) and the specificity of 65% (95% Cl:38-86%). If, in addition, lymphadenopathy is not taken as definite evidence of inoperability, the specificity rises to 82% (95%Cl:57-96%). A high quality CT scan is highly specific for predicting inoperability based on extension of the tumor to the pelvic side walls, encasement of adjacent vessels or ureteric dilatation and so should be a major tool in assessing women for radical surgical treatment of recurrent cervical cancer. If ascites is the only abnormal finding other than the central pelvic mass then exploration should be undertaken.
Persistent Identifierhttp://hdl.handle.net/10722/87016
ISSN
2015 Impact Factor: 2.116
2015 SCImago Journal Rankings: 0.830
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCrawford, RAFen_HK
dc.contributor.authorRichards, PJen_HK
dc.contributor.authorReznek, RHen_HK
dc.contributor.authorNgan, HYSen_HK
dc.contributor.authorShepherd, JHen_HK
dc.date.accessioned2010-09-06T09:24:13Z-
dc.date.available2010-09-06T09:24:13Z-
dc.date.issued1996en_HK
dc.identifier.citationInternational Journal Of Gynecological Cancer, 1996, v. 6 n. 3, p. 231-234en_HK
dc.identifier.issn1048-891Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/87016-
dc.description.abstractIn women with recurrent cervical cancer, there is a 52% 5-year survival rate when exenteration of the centrally placed tumor is performed. If not exenterated, the 2-year survival rate is less than 2%. The purpose of this study is to ascertain whether CT can predict inoperability reliably leading to a reduction in operations which do not have a curative outcome. The records of patients with recurrence of cervical cancer who underwent laparotomies for exenteration over the last 10 years under the care of one surgeon were reviewed. The CT scans were retrospectively assessed by two radiologists without knowledge of the subsequent outcome of the laparotomy. CT scans on 31 patients were reviewed, 21 of whom underwent a radical surgical procedure. Using CT criteria, 9 cases were felt to be operable with a curative intent and the remaining 22 cases were deemed to be inoperable. The sensitivity of CT prediction of inoperability is 93% (95%Cl:66-100%) and the specificity is 47% (95%Cl:23-72%). In three cases ascites was the only abnormal finding other than the central pelvic mass and in all of these cases a radical procedure with clear resection margins was possible. When the group with ascites alone was not considered to have peritoneal disease underlying the ascites, the sensitivity of CT prediction of inoperability is 93% (95%Cl:66-100%) and the specificity of 65% (95% Cl:38-86%). If, in addition, lymphadenopathy is not taken as definite evidence of inoperability, the specificity rises to 82% (95%Cl:57-96%). A high quality CT scan is highly specific for predicting inoperability based on extension of the tumor to the pelvic side walls, encasement of adjacent vessels or ureteric dilatation and so should be a major tool in assessing women for radical surgical treatment of recurrent cervical cancer. If ascites is the only abnormal finding other than the central pelvic mass then exploration should be undertaken.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.ijgc.net/en_HK
dc.relation.ispartofInternational Journal of Gynecological Canceren_HK
dc.subjectascitesen_HK
dc.subjectcervical canceren_HK
dc.subjectCTen_HK
dc.subjectexenterationen_HK
dc.titleThe role of CT in predicting the surgical feasibility of exenteration in recurrent carcinoma of the cervixen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1048-891X&volume=6&spage=231&epage=234&date=1996&atitle=The+role+of+CT+in+predicting+the+surgical+feasibility+of+exenteration+in+recurrent+carcinoma+of+the+cervixen_HK
dc.identifier.emailNgan, HYS:hysngan@hkucc.hku.hken_HK
dc.identifier.authorityNgan, HYS=rp00346en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1046/j.1525-1438.1996.06030231.xen_HK
dc.identifier.scopuseid_2-s2.0-0029936460en_HK
dc.identifier.hkuros11037en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0029936460&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume6en_HK
dc.identifier.issue3en_HK
dc.identifier.spage231en_HK
dc.identifier.epage234en_HK
dc.identifier.isiWOS:A1996UH51600013-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridCrawford, RAF=7402584619en_HK
dc.identifier.scopusauthoridRichards, PJ=8731621800en_HK
dc.identifier.scopusauthoridReznek, RH=7005121521en_HK
dc.identifier.scopusauthoridNgan, HYS=34571944100en_HK
dc.identifier.scopusauthoridShepherd, JH=7401741987en_HK

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