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Quantitative X-ray computed tomography peritoneography in malignant peritoneal mesothelioma patients receiving intraperitoneal chemotherapy.

Authors :
Leinwand JC
Zhao B
Guo X
Krishnamoorthy S
Qi J
Graziano JH
Slavkovic VN
Bates GE
Lewin SN
Allendorf JD
Chabot JA
Schwartz LH
Taub RN
Source :
Annals of surgical oncology [Ann Surg Oncol] 2013 Dec; Vol. 20 Suppl 3, pp. S553-9. Date of Electronic Publication: 2013 May 24.
Publication Year :
2013

Abstract

Background: Intraperitoneal chemotherapy is used to treat peritoneal surface-spreading malignancies. We sought to determine whether volume and surface area of the intraperitoneal chemotherapy compartments are associated with overall survival and posttreatment glomerular filtration rate (GFR) in malignant peritoneal mesothelioma (MPM) patients.<br />Methods: Thirty-eight MPM patients underwent X-ray computed tomography peritoneograms during outpatient intraperitoneal chemotherapy. We calculated volume and surface area of contrast-filled compartments by semiautomated computer algorithm. We tested whether these were associated with overall survival and posttreatment GFR.<br />Results: Decreased likelihood of mortality was associated with larger surface areas (p = 0.0201) and smaller contrast-filled compartment volumes (p = 0.0341), controlling for age, sex, histologic subtype, and presence of residual disease >0.5 cm postoperatively. Larger volumes were associated with higher posttreatment GFR, controlling for pretreatment GFR, body surface area, surface area, and the interaction between body surface area and volume (p = 0.0167).<br />Discussion: Computed tomography peritoneography is an appropriate modality to assess for maldistribution of intraperitoneal chemotherapy. In addition to identifying catheter failure and frank loculation, quantitative analysis of the contrast-filled compartment's surface area and volume may predict overall survival and cisplatin-induced nephrotoxicity. Prospective studies should be undertaken to confirm and extend these findings to other diseases, including advanced ovarian carcinoma.

Details

Language :
English
ISSN :
1534-4681
Volume :
20 Suppl 3
Database :
MEDLINE
Journal :
Annals of surgical oncology
Publication Type :
Academic Journal
Accession number :
23702640
Full Text :
https://doi.org/10.1245/s10434-013-2976-8