European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 148, Issue 2 , Pages 182-185, February 2010

Preoperative assessment of complete tumour resection by magnetic resonance imaging in patients undergoing pelvic exenteration

  • Dirk Michael Forner

      Affiliations

    • Kaiserswerther Diakonie, Florence Nightingale Hospital, Kreuzbergstraße 79, D-40489 Duesseldorf, Germany
    • Corresponding Author InformationCorresponding author at: Kaiserswerther Diakonie, Florence Nightingale Hospital, Obstetrics and Gynaecology, Kreuzbergstraße 79, D-40489 Duesseldorf, Germany. Tel.: +49 211 4092519; fax: +49 211 4092254.
  • ,
  • Ansgar Meyer

      Affiliations

    • Radiologisches Netzwerk Rheinland/Standort Klinikum Leverkusen, Am Gesundheitspark 11, D-51375 Leverkusen, Germany
  • ,
  • Bjoern Lampe

      Affiliations

    • Kaiserswerther Diakonie, Florence Nightingale Hospital, Kreuzbergstraße 79, D-40489 Duesseldorf, Germany
    • Tel.: +49 211 4092519; fax: +49 211 4092254.

Received 6 May 2009; received in revised form 17 August 2009; accepted 19 October 2009. published online 09 November 2009.

Abstract 

Objectives

To evaluate whether preoperative magnetic resonance imaging (MRI) allows prediction of complete tumour resection in patients planned for pelvic exenteration (PE).

Study design

Data of all patients treated by PE at a gynaecologic cancer centre between 6/1999 and 5/2005 were studied retrospectively. Preoperative MRI scans were re-analysed blindly with respect to invasion of neighbouring organs, muscular pelvic side wall, vessels and lymph nodes by an experienced team of radiologist and gynaecologic oncologist, finally also giving estimation whether complete removal of tumour would be feasible.

Results

43 patients were identified: all of them underwent PE. The histopathological investigation of the exenteration specimen demonstrated microscopic complete resection status in 20 cases (46.5%). None of the investigated parameter showed a correlation to complete resection of tumour. Sensitivity for final microscopic results relative to preoperative prediction by radiographic findings was 85%, specificity was 52%. The positive predictive value for tumour-free status was 60% (17/28), the negative 80% (12/15).

Conclusions

Preoperative MRI cannot predict the surgical outcome with sufficient accuracy, hence on its own is inappropriate for prediction of complete tumour resection and final histological margin status in patients undergoing PE.

Keywords: Pelvic exenteration, MRI, Genital neoplasm, Magnetic resonance imaging

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0301-2115(09)00638-1

doi:10.1016/j.ejogrb.2009.10.022

European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 148, Issue 2 , Pages 182-185, February 2010