Predicting resectability of periampullary cancer with three-dimensional computed tomography
The radiographic assessment of extent of tumor burden and local vascular invasion appears to be enhanced with three-dimensional computed tomography (3D-CT). The purpose of this study was to evaluate the impact of preoperative 3D-CT in determining the resectability of patients with periampullary tumo...
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Veröffentlicht in: | Journal of gastrointestinal surgery 2004-03, Vol.8 (3), p.280-288 |
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description | The radiographic assessment of extent of tumor burden and local vascular invasion appears to be enhanced with three-dimensional computed tomography (3D-CT). The purpose of this study was to evaluate the impact of preoperative 3D-CT in determining the resectability of patients with periampullary tumors. Intraoperative findings from exploratory laparotomy were gathered prospectively from 140 patients who were thought to have periampullary tumors and were deemed resectable after undergoing preoperative 3D-CT imaging. CT findings were compared to intraoperative findings, and the accuracy of 3D-CT in predicting tumor resectability and, ultimately, the likelihood of obtaining a margin-negative resection were assessed. Of the 140 patients who were thought to have resectable periampullary tumors after preoperative 3D-CT, 115 (82%) were subsequently determined to have periampullary cancer. The remaining 25 patients had benign disease. Among the patients with periampullary cancer, the extent of local tumor burden involving the pancreas and peripancreatic tissues was accurately depicted by 3D-CT in 93% of the patients. 3D-CT was 95% accurate in determining cancer invasion of the superior mesenteric vessels. Preoperative 3D-CT accurately predicted periampullary cancer resectability and a margin-negative resection in 98% and 86% of patients, respectively. For patients with pancreatic adenocarcinoma (n=85), preoperative 3D-CT resulted in a resectability rate and a margin-negative resection rate of 79% and 73%, respectively. The ability of 3D-CT to predict a margin-negative resection for periampullary cancer, including pancreatic adenocarcinoma, relies on its enhanced assessment of the extent of local tumor burden and involvement of the mesenteric vascular anatomy. |
doi_str_mv | 10.1016/j.gassur.2003.12.011 |
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The purpose of this study was to evaluate the impact of preoperative 3D-CT in determining the resectability of patients with periampullary tumors. Intraoperative findings from exploratory laparotomy were gathered prospectively from 140 patients who were thought to have periampullary tumors and were deemed resectable after undergoing preoperative 3D-CT imaging. CT findings were compared to intraoperative findings, and the accuracy of 3D-CT in predicting tumor resectability and, ultimately, the likelihood of obtaining a margin-negative resection were assessed. Of the 140 patients who were thought to have resectable periampullary tumors after preoperative 3D-CT, 115 (82%) were subsequently determined to have periampullary cancer. The remaining 25 patients had benign disease. Among the patients with periampullary cancer, the extent of local tumor burden involving the pancreas and peripancreatic tissues was accurately depicted by 3D-CT in 93% of the patients. 3D-CT was 95% accurate in determining cancer invasion of the superior mesenteric vessels. Preoperative 3D-CT accurately predicted periampullary cancer resectability and a margin-negative resection in 98% and 86% of patients, respectively. For patients with pancreatic adenocarcinoma (n=85), preoperative 3D-CT resulted in a resectability rate and a margin-negative resection rate of 79% and 73%, respectively. The ability of 3D-CT to predict a margin-negative resection for periampullary cancer, including pancreatic adenocarcinoma, relies on its enhanced assessment of the extent of local tumor burden and involvement of the mesenteric vascular anatomy.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1016/j.gassur.2003.12.011</identifier><identifier>PMID: 15019924</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenocarcinoma - diagnostic imaging ; Adenocarcinoma - surgery ; Ampulla of Vater ; Cancer ; Celiac Artery ; Common Bile Duct Neoplasms - diagnostic imaging ; Common Bile Duct Neoplasms - surgery ; computed tomography ; Female ; Hepatic Artery ; Humans ; Imaging, Three-Dimensional ; Male ; Mesenteric Artery, Superior ; Middle Aged ; Neoplasm Invasiveness ; Pancreatic Neoplasms - diagnostic imaging ; Pancreatic Neoplasms - surgery ; Periampullary cancer ; Predictive Value of Tests ; Preoperative Care ; Prospective Studies ; resection ; Sensitivity and Specificity ; Tomography, X-Ray Computed - methods ; Tumors ; vascular invasion</subject><ispartof>Journal of gastrointestinal surgery, 2004-03, Vol.8 (3), p.280-288</ispartof><rights>2004 The Society for Surgery of the Alimentary Tract</rights><rights>The Society for Surgery of the Alimentary Tract, Inc. 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c388t-a2d2e6f080deb6bd46bbec31b5201f001beb8b7d62b9a3f5d0b0f1452bf1bf3d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15019924$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>House, Michael G</creatorcontrib><creatorcontrib>Yeo, Charles J</creatorcontrib><creatorcontrib>Cameron, John L</creatorcontrib><creatorcontrib>Campbell, Kurt A</creatorcontrib><creatorcontrib>Schulick, Richard D</creatorcontrib><creatorcontrib>Leach, Steven D</creatorcontrib><creatorcontrib>Hruban, Ralph H</creatorcontrib><creatorcontrib>Horton, Karen M</creatorcontrib><creatorcontrib>Fishman, Elliot K</creatorcontrib><creatorcontrib>Lillemoe, Keith D</creatorcontrib><title>Predicting resectability of periampullary cancer with three-dimensional computed tomography</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><description>The radiographic assessment of extent of tumor burden and local vascular invasion appears to be enhanced with three-dimensional computed tomography (3D-CT). The purpose of this study was to evaluate the impact of preoperative 3D-CT in determining the resectability of patients with periampullary tumors. Intraoperative findings from exploratory laparotomy were gathered prospectively from 140 patients who were thought to have periampullary tumors and were deemed resectable after undergoing preoperative 3D-CT imaging. CT findings were compared to intraoperative findings, and the accuracy of 3D-CT in predicting tumor resectability and, ultimately, the likelihood of obtaining a margin-negative resection were assessed. Of the 140 patients who were thought to have resectable periampullary tumors after preoperative 3D-CT, 115 (82%) were subsequently determined to have periampullary cancer. The remaining 25 patients had benign disease. Among the patients with periampullary cancer, the extent of local tumor burden involving the pancreas and peripancreatic tissues was accurately depicted by 3D-CT in 93% of the patients. 3D-CT was 95% accurate in determining cancer invasion of the superior mesenteric vessels. Preoperative 3D-CT accurately predicted periampullary cancer resectability and a margin-negative resection in 98% and 86% of patients, respectively. For patients with pancreatic adenocarcinoma (n=85), preoperative 3D-CT resulted in a resectability rate and a margin-negative resection rate of 79% and 73%, respectively. The ability of 3D-CT to predict a margin-negative resection for periampullary cancer, including pancreatic adenocarcinoma, relies on its enhanced assessment of the extent of local tumor burden and involvement of the mesenteric vascular anatomy.</description><subject>Adenocarcinoma - diagnostic imaging</subject><subject>Adenocarcinoma - surgery</subject><subject>Ampulla of Vater</subject><subject>Cancer</subject><subject>Celiac Artery</subject><subject>Common Bile Duct Neoplasms - diagnostic imaging</subject><subject>Common Bile Duct Neoplasms - surgery</subject><subject>computed tomography</subject><subject>Female</subject><subject>Hepatic Artery</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional</subject><subject>Male</subject><subject>Mesenteric Artery, Superior</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness</subject><subject>Pancreatic Neoplasms - diagnostic imaging</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Periampullary cancer</subject><subject>Predictive Value of Tests</subject><subject>Preoperative Care</subject><subject>Prospective Studies</subject><subject>resection</subject><subject>Sensitivity and Specificity</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Tumors</subject><subject>vascular invasion</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1r3DAQhkVpaNK0_6AUQ6E3Oxr5S74EQugXBJJDCoUehD5Gu1psy5HkhP33VdiFQA85zRyed-blIeQT0AoodBe7aiNjXEPFKK0rYBUFeEPOgPd12XSse5t3OkDJ2vbPKXkf445S6Cnwd-QUWgrDwJoz8vcuoHE6uXlTBIyok1RudGlfeFssGJyclnUcZdgXWs4aQ_Hk0rZI24BYGjfhHJ2f5Vhon8GEpkh-8psgl-3-Azmxcoz48TjPye_v3-6vf5Y3tz9-XV_dlLrmPJWSGYadpZwaVJ0yTacU6hpUyyjYXFqh4qo3HVODrG1rqKIWmpYpC8rWpj4nXw93l-AfVoxJTC5qzK1n9GsUPfSsBT5k8Mt_4M6vIbePAgBYzSnvIVPNgdLBxxjQiiW4KRsQQMWzerETB_XiWb0AJrL6HPt8PL6qCc1L6Og6A5cHALOLR4dBRO0wOzUuZO_CePf6h38w_Zlz</recordid><startdate>20040301</startdate><enddate>20040301</enddate><creator>House, Michael G</creator><creator>Yeo, Charles J</creator><creator>Cameron, John L</creator><creator>Campbell, Kurt A</creator><creator>Schulick, Richard D</creator><creator>Leach, Steven D</creator><creator>Hruban, Ralph H</creator><creator>Horton, Karen M</creator><creator>Fishman, Elliot K</creator><creator>Lillemoe, Keith D</creator><general>Elsevier Inc</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20040301</creationdate><title>Predicting resectability of periampullary cancer with three-dimensional computed tomography</title><author>House, Michael G ; Yeo, Charles J ; Cameron, John L ; Campbell, Kurt A ; Schulick, Richard D ; Leach, Steven D ; Hruban, Ralph H ; Horton, Karen M ; Fishman, Elliot K ; Lillemoe, Keith D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c388t-a2d2e6f080deb6bd46bbec31b5201f001beb8b7d62b9a3f5d0b0f1452bf1bf3d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adenocarcinoma - diagnostic imaging</topic><topic>Adenocarcinoma - surgery</topic><topic>Ampulla of Vater</topic><topic>Cancer</topic><topic>Celiac Artery</topic><topic>Common Bile Duct Neoplasms - diagnostic imaging</topic><topic>Common Bile Duct Neoplasms - surgery</topic><topic>computed tomography</topic><topic>Female</topic><topic>Hepatic Artery</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional</topic><topic>Male</topic><topic>Mesenteric Artery, Superior</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness</topic><topic>Pancreatic Neoplasms - diagnostic imaging</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Periampullary cancer</topic><topic>Predictive Value of Tests</topic><topic>Preoperative Care</topic><topic>Prospective Studies</topic><topic>resection</topic><topic>Sensitivity and Specificity</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Tumors</topic><topic>vascular invasion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>House, Michael G</creatorcontrib><creatorcontrib>Yeo, Charles J</creatorcontrib><creatorcontrib>Cameron, John L</creatorcontrib><creatorcontrib>Campbell, Kurt A</creatorcontrib><creatorcontrib>Schulick, Richard D</creatorcontrib><creatorcontrib>Leach, Steven D</creatorcontrib><creatorcontrib>Hruban, Ralph H</creatorcontrib><creatorcontrib>Horton, Karen M</creatorcontrib><creatorcontrib>Fishman, Elliot K</creatorcontrib><creatorcontrib>Lillemoe, Keith D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>House, Michael G</au><au>Yeo, Charles J</au><au>Cameron, John L</au><au>Campbell, Kurt A</au><au>Schulick, Richard D</au><au>Leach, Steven D</au><au>Hruban, Ralph H</au><au>Horton, Karen M</au><au>Fishman, Elliot K</au><au>Lillemoe, Keith D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predicting resectability of periampullary cancer with three-dimensional computed tomography</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><addtitle>J Gastrointest Surg</addtitle><date>2004-03-01</date><risdate>2004</risdate><volume>8</volume><issue>3</issue><spage>280</spage><epage>288</epage><pages>280-288</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>The radiographic assessment of extent of tumor burden and local vascular invasion appears to be enhanced with three-dimensional computed tomography (3D-CT). The purpose of this study was to evaluate the impact of preoperative 3D-CT in determining the resectability of patients with periampullary tumors. Intraoperative findings from exploratory laparotomy were gathered prospectively from 140 patients who were thought to have periampullary tumors and were deemed resectable after undergoing preoperative 3D-CT imaging. CT findings were compared to intraoperative findings, and the accuracy of 3D-CT in predicting tumor resectability and, ultimately, the likelihood of obtaining a margin-negative resection were assessed. Of the 140 patients who were thought to have resectable periampullary tumors after preoperative 3D-CT, 115 (82%) were subsequently determined to have periampullary cancer. The remaining 25 patients had benign disease. Among the patients with periampullary cancer, the extent of local tumor burden involving the pancreas and peripancreatic tissues was accurately depicted by 3D-CT in 93% of the patients. 3D-CT was 95% accurate in determining cancer invasion of the superior mesenteric vessels. Preoperative 3D-CT accurately predicted periampullary cancer resectability and a margin-negative resection in 98% and 86% of patients, respectively. For patients with pancreatic adenocarcinoma (n=85), preoperative 3D-CT resulted in a resectability rate and a margin-negative resection rate of 79% and 73%, respectively. The ability of 3D-CT to predict a margin-negative resection for periampullary cancer, including pancreatic adenocarcinoma, relies on its enhanced assessment of the extent of local tumor burden and involvement of the mesenteric vascular anatomy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>15019924</pmid><doi>10.1016/j.gassur.2003.12.011</doi><tpages>9</tpages></addata></record> |
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subjects | Adenocarcinoma - diagnostic imaging Adenocarcinoma - surgery Ampulla of Vater Cancer Celiac Artery Common Bile Duct Neoplasms - diagnostic imaging Common Bile Duct Neoplasms - surgery computed tomography Female Hepatic Artery Humans Imaging, Three-Dimensional Male Mesenteric Artery, Superior Middle Aged Neoplasm Invasiveness Pancreatic Neoplasms - diagnostic imaging Pancreatic Neoplasms - surgery Periampullary cancer Predictive Value of Tests Preoperative Care Prospective Studies resection Sensitivity and Specificity Tomography, X-Ray Computed - methods Tumors vascular invasion |
title | Predicting resectability of periampullary cancer with three-dimensional computed tomography |
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