Advertisement
AJOG Home
Advanced SearchSave search
Original Research: Gynecology|Articles in Press

Diagnostic performance of ultrasound in assessing the extension of disease in advanced ovarian cancer

  • Maria Cristina Moruzzi
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
    Search for articles by this author
  • Giulia Bolomini
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
    Search for articles by this author
  • Rosanna Esposito
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
    Search for articles by this author
  • Floriana Mascilini
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
    Search for articles by this author
  • Francesca Ciccarone
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
    Search for articles by this author
  • Lorena Quagliozzi
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
    Search for articles by this author
  • Maria Teresa Giudice
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
    Search for articles by this author
  • Giuliana Beneduce
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
    Search for articles by this author
  • Silvia Ficarelli
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
    Search for articles by this author
  • Rossana Moroni
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Direzione Scientifica, Rome, Italy
    Search for articles by this author
  • Giovanni Scambia
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy

    Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
    Search for articles by this author
  • Anna Fagotti
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy

    Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
    Search for articles by this author
  • Antonia Carla Testa
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy

    Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
    Search for articles by this author
  • Francesca Moro
    Correspondence
    Corresponding author: Francesca Moro, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy, , Phone number: +390630156399
    Affiliations
    Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
    Search for articles by this author
Published:June 22, 2022DOI:https://doi.org/10.1016/j.ajog.2022.05.029
Diagnostic performance of ultrasound in assessing the extension of disease in advanced ovarian cancer
Previous ArticlePercutaneous/mini-laparotomy fetoscopic repair of open spina bifida: a novel surgical technique
Next ArticleExpectant versus medical management for retained products of conception after medical termination of pregnancy: A randomized controlled study
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Background

      Surgical exploration remains the gold standard to evaluate the extension of disease and predict resectability. A laparoscopy-based scoring model was developed by Fagotti and colleagues in 2006 and updated in 2015, based on the intraoperative presence or absence of some specific cancer features. The model proved an overall accuracy rate of 77-100% and is considered the reference test to assess resectability in our Institution.

      Objectives

      The primary aim of the study was to analyze the agreement between preoperative ultrasound examination and laparoscopic findings in assessing the extension of intra-abdominal disease using six parameters described by Fagotti’s score.

      Study design

      This is a prospective single-center observational study. Between January 2019 and June 2020, consecutive patients with clinical or radiological suspicion of ovarian/peritoneal cancer were assessed with preoperative ultrasound examination and assigned a score based on the six Fagotti’s score parameters (great omentum, liver surface, lesser omentum/stomach/spleen, parietal peritoneum, diaphragms, bowel disease). Presence of mesenteral retraction of the small bowel and miliaric carcinomatosis on the serosa were also evaluated. Each parameter was correlated with laparoscopic findings. Concordance was calculated between ultrasound and laparoscopic parameters using Cohen’s kappa(κ).

      Results

      Cohen’s κ ranged from 0.70 to 0.90 for carcinomatosis on the small/large bowel, supracolic omentum, liver surface and diaphragms. Cohen’s κ test was lower for carcinomatosis on the parietal peritoneum (k=0.63) and on the lesser omentum/lesser curvature of the stomach/spleen (k=0.54). The agreement between ultrasound and surgical predictive index value (score) was κ=0.74. For the evaluation of mesenteral retraction and miliaric carcinomatosis, the agreement was low (k=0.57 and k=0.36 respectively).

      Conclusions

      The results of ultrasound and laparoscopy in the assessment of intra-abdominal tumor spread were in substantial agreement for almost all the parameters. Ultrasound examination can play a useful role in the preoperative management of patients with ovarian cancer when used in dedicated referral centers.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      Article Info

      Publication History

      Accepted: May 10, 2022
      Received in revised form: May 4, 2022
      Received: December 24, 2021

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      The authors reported no conflict of interest.

      Condensation

      Diagnostic performance of ultrasound in the assessment of disease extension in patients with suspected advanced ovarian cancer: comparison between ultrasound and laparoscopy.

      A. Few data are available in the literature regarding the accuracy of ultrasound in detecting intraabdominal ovarian cancer spread and the estimation of the probability of optimal cytoreduction.

      B. The results of ultrasound and laparoscopy in the assessment of intra-abdominal tumor spread were in substantial agreement for almost all the parameters.

      C. This study could open up new strategies in the management of patients with advanced ovarian cancer. For example, ultrasound examination could be an alternative diagnostic tool to Computed Tomography (CT) scan for those patients allergic to contrast media. Imaging methods (ultrasound examination or CT scan) could be useful in the case of patients unsuitable for diagnostic surgery due to severe comorbidities or clear evidence of advanced unresectable disease, and to perform a biopsy for quick histological diagnosis and molecular profiling.

      Identification

      DOI: https://doi.org/10.1016/j.ajog.2022.05.029

      Copyright

      © 2022 Elsevier Inc. All rights reserved.

      ScienceDirect

      Access this article on ScienceDirect
      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the for this site.
      Copyright © 2022 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.


      RELX