abstract
To
study the frequency, timing, and associations of
thoracic metastases in
advanced (stage III and IV) high-grade serous ovarian cancer (HGSC) to
help optimize the use of cross-sectional chest imaging.
This
institutional review board–approved retrospective study with waived
informed consent included 186 consecutive patients with pathologically
proven advanced HGSC after primary cytoreduction (mean age ± standard
deviation, 60 years ± 9.7) who underwent imaging at our tertiary cancer
institution from January 2012 to December 2012 with at least 1 year of
follow-up, unless there was thoracic metastasis or death. Electronic
medical records and all available imaging studies were reviewed to
record patient and tumor characteristics, frequency and timing of
abdominal and thoracic metastases, and visibility of the first
thoracoabdominal metastasis on abdominal images. Patient and tumor
characteristics associated with thoracic metastases were studied by
using univariate and multivariate Cox proportional analysis.
After
median follow-up of 57 months (interquartile range [IQR], 38–93), 175
patients (94%) developed metastatic disease; each had abdominal disease,
and 76 (41%) had thoracic metastases.
The first thoracoabdominal
metastasis was visible on abdominal images in all 175 patients. The
thoracic metastasis–free interval was longer than the abdominal
disease–free interval (median, 85 months [IQR, 28–131] vs 14 months
[IQR, 7–27], respectively;
P < .0001). Presence of disease on
abdominal images (hazard ratio, 2.56; 95% confidence interval: 1.35,
4.76) was the only factor independently associated with thoracic
metastases.
Thoracic
metastases in advanced HGSC rarely occur before abdominal disease, and
first thoracoabdominal metastases are invariably visible on abdominal
images. Therefore, cross-sectional chest imaging may be deferred until
development of abdominal disease, with minimal risk of missing thoracic
metastases.
0 comments :
Post a Comment
Your comments?
Note: Only a member of this blog may post a comment.