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Titolo:
How accurate is helical computed tomography for clinical staging of pancreatic cancer?
Autore:
Taoka, H; Hauptmann, E; Traverso, LW; Barnett, MJ; Sarr, MG; Reber, HA;
Indirizzi:
Virginia Mason Med Ctr, Dept Gen Surg, Sect Gen Surg, Seattle, WA 98111 USA Virginia Mason Med Ctr Seattle WA USA 98111 n Surg, Seattle, WA 98111 USA Virginia Mason Med Ctr, Sect Radiol, Seattle, WA 98111 USA Virginia Mason Med Ctr Seattle WA USA 98111 Radiol, Seattle, WA 98111 USA Mayo Clin, Dept Surg, Rochester, MN USA Mayo Clin Rochester MN USAMayo Clin, Dept Surg, Rochester, MN USA Univ Calif Los Angeles, Sect Gastrointestinal Surg, Los Angeles, CA USA Univ Calif Los Angeles Los Angeles CA USA inal Surg, Los Angeles, CA USA
Titolo Testata:
AMERICAN JOURNAL OF SURGERY
fascicolo: 5, volume: 177, anno: 1999,
pagine: 428 - 432
SICI:
0002-9610(199905)177:5<428:HAIHCT>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
ADENOCARCINOMA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
5
Recensione:
Indirizzi per estratti:
Indirizzo: Traverso, LW Virginia Mason Med Ctr, Dept Gen Surg, Sect Gen Surg, 1100 9th Ave,C6-GSUR, Virginia Mason Med Ctr 1100 9th Ave,C6-GSUR Seattle WA USA 98111
Citazione:
H. Taoka et al., "How accurate is helical computed tomography for clinical staging of pancreatic cancer?", AM J SURG, 177(5), 1999, pp. 428-432

Abstract

BACKGROUND: Our goal was to determine if findings on an index computed tomography (CT) scan would correlate with survival in patients with pancreaticadenocarcinoma. We know that as this tumor extends out of the gland, survival decreases. Are there any CT findings that assess tumor extension sufficiently that also correlate with survival? Once identified, these CT areas would be the best factors to clinically stage patients. METHODS: Between 1993 and 1997, 160 patients with biopsy-proven adenocarcinoma of the pancreatic head were included if an index helical CT scan and clinical follow-up were available. All CT scans were reviewed by the same radiologist blinded for outcomes. CT scans were interpreted using a graded extension of tumor out of the pancreatic head in four areas: retroperitoneum (RP); anterior pancreatic capsule (S); portal/superior mesenteric veins (PV); and celiac/superior mesenteric arteries (A), Extension of tumor was graded as follows: Grade 0 (negative margin); 1 (suspicious); 2 (positive); or 3 (extensively involved). Also recorded and graded were signs of metastases: nodal enlargement greater than or equal to 1.5 cm (N); and lesions consistent with hepatic metastases (H), Survival was compared between grades for each CT area using the methods of Kaplan and Meier and relative risk estimates of death (Cox regression models). RESULTS: Compared with grade 0, the following CT areas had significantly decreased survival curves: grade 1 (only S and A), grade 2 and 3 (RP, PV, S,A). N and H did not correlate with survival unless greater than or equal to 1.5 cm nodes were in the liver or splenic hilum or there were multiple liver nodules. CONCLUSION: Although postoperative microscopic H or N involvement is a reliable prognostic sign, only extensive CT involvement of H or N predicts survival preoperatively. A better CT finding that predicts decreased survival preoperatively was extension out of the pancreatic head (especially S or A). Clinical methods of staging should use CT areas such as S, A, PV, and RP,and not H and N. Am J Surg. 1999;177:428-432. (C) 1999 by Excerpta Medica,Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 00:17:51