Concerning CT features used to select patients for treatment of peritoneal metastases, a pictoral essay.

Details

Serval ID
serval:BIB_26DF706F1ED9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Concerning CT features used to select patients for treatment of peritoneal metastases, a pictoral essay.
Journal
International journal of hyperthermia
Author(s)
Sugarbaker P.H., Sardi A., Brown G., Dromain C., Rousset P., Jelinek J.S.
ISSN
1464-5157 (Electronic)
ISSN-L
0265-6736
Publication state
Published
Issued date
08/2017
Peer-reviewed
Oui
Volume
33
Number
5
Pages
497-504
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
During the Fifth International Workshop on Peritoneal Surface Malignancy in Milan in 2008, a consensus was reached that contrast-enhanced CT (ceCT) was the principal imaging modality for patients being evaluated for treatment of peritoneal metastases. This fact being accepted, the radiologic criteria for that may exclude patients from a high value cytoreductive surgery (CRS) plus hyperthermic perioperative chemotherapy (HIPEC) have not been reliably determined.
From a consensus of surgeons and radiologists, radiologic images were selected and their determinant radiologic characteristics described. The anatomic pathology causing the abnormal images were identified and characterised. The cytoreductive surgical procedures that may, in selected patients, result in a complete resection of the pathology identified were presented.
Radiographs of 15 CT images that cause concern when a patient is being evaluated for CRS were listed. The anatomic pathology these images define and possible surgical resections they require were reviewed. The surgical implications of the absence or presence of a single, or of multiple concerning CT features was extracted from the surgical and radiologic literature.
There is a definite need to identify new pre-operative imaging parameters to define optimal indication of CRS with HIPEC. The presence of a single concerning radiologic feature is associated with the possibility of an adverse outcome or technically more complex resections associated with increased morbidity and mortality. If two or more of the concerning radiologic features are described from the CT, suboptimal cytoreduction will usually occur.

Keywords
Cytoreduction Surgical Procedures/methods, Female, Humans, Male, Peritoneal Neoplasms/pathology, Peritoneal Neoplasms/surgery, Peritoneal Neoplasms/therapy, Tomography, X-Ray Computed/methods, Cytoreductive surgery, HIPEC, contrast-enhanced CT, histologic diagnosis, parietal peritonectomy, small bowel mesentery, visceral peritonectomy
Pubmed
Web of science
Create date
06/06/2017 20:43
Last modification date
20/08/2019 13:05
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