Pseudomyxoma peritonei: visceral scalloping on CT is a predictor of recurrence after complete cytoreductive surgery.
Adult
Aged
Biomarkers, Tumor
/ analysis
Contrast Media
Cytoreduction Surgical Procedures
Disease-Free Survival
Female
Humans
Hyperthermia, Induced
Male
Middle Aged
Mucins
/ analysis
Neoplasm Recurrence, Local
/ diagnostic imaging
Peritoneal Neoplasms
/ diagnostic imaging
Peritoneum
/ diagnostic imaging
Prognosis
Pseudomyxoma Peritonei
/ diagnostic imaging
Retrospective Studies
Tomography, X-Ray Computed
/ methods
Disease-free survival
Multidetector computed tomography
Prognosis
Pseudomyxoma peritonei
Recurrence
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
31
01
2020
accepted:
17
02
2020
revised:
08
02
2020
pubmed:
27
3
2020
medline:
17
12
2020
entrez:
27
3
2020
Statut:
ppublish
Résumé
Pseudomyxoma peritonei (PMP) is characterized by peritoneal dissemination of gelatinous ascites following rupture of a mucinous tumor. Treatment by cytoreductive surgery (CRS) has improved its prognosis. Although visceral scalloping, notably liver scalloping, on computed tomography (CT) is a typical feature of PMP, its prognostic value remains unknown. We aimed to investigate the efficacy of liver scalloping in predicting recurrence in PMP patients. Among 159 consecutive patients with PMP who had contrast-enhanced CT between September 2012 and December 2018, 64 treatment-naïve patients who subsequently underwent CRS with complete resection (i.e., completeness of cytoreduction score (CC)-0 or CC-1), were included in analysis. Presence of liver scalloping and maximum thickness of mucin deposition at the liver surface were evaluated on CT. Disease-free survival (DFS) was determined based on the combination of postoperative CT features and tumor marker values. Median follow-up was 24.3 months. CT revealed liver scalloping in 40/64 (63.4%) patients. Kaplan-Meier analysis showed significantly shorter DFS in patients with scalloping than in those without (p = 0.001; hazard ratio, 4.3). In patients with scalloping, greater mucin deposition (thickness ≥ 20 mm) significantly correlated with poorer DFS (p = 0.042). In multivariate Cox proportional hazards regression including CC status, pathologic type, and tumor markers, the presence of scalloping independently and significantly correlated with DFS (p = 0.031). Liver scalloping was an independent predictor even after adjusting for clinical covariates. The presence of liver scalloping can lead to a high recurrence rate after CRS. • The presence of liver scalloping is a prognostic factor independent of histological grade and tumor markers. • Greater mucin deposition (thickness ≥ 20 mm at the liver surface) is associated with higher recurrence rates in patients with liver scalloping.
Identifiants
pubmed: 32211961
doi: 10.1007/s00330-020-06756-2
pii: 10.1007/s00330-020-06756-2
doi:
Substances chimiques
Biomarkers, Tumor
0
Contrast Media
0
Mucins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4193-4200Références
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