Ultrasound in preoperative assessment of pelvic and abdominal spread in patients with ovarian cancer: a prospective study
Abstract
Objective: To analyze the accuracy of ultrasound in assessing pelvic and intra-abdominal spread in patients with ovarian cancer. Methods This prospective study enrolled all consecutive patients referred to a single gynecological oncology center for suspected ovarian cancer.
We analyzed only data from patients with histologically confirmed primary ovarian cancer who were evaluated following predefined preoperative ultrasound, intraoperative and pathology protocols. We evaluated the agreement of depth of infiltration of the rectosigmoid wall, tumor spread in different peritoneal compartments and presence of metastatic retroperitoneal and inguinal lymph nodes, as determined at ultrasound, with intraoperative and histopathological findings.
Conclusion: This is the largest imaging study to date on ovarian cancer staging. Ultrasound can be used as the method of choice to plan rectosigmoid wall resection and dissection of infiltrated inguinal lymph nodes.
In assessing different peritoneal and retroperitoneal compartments, ultrasound was accurate and highly specific. However, similar to other modern imaging techniques, it had relatively low sensitivity, further supporting the role of comprehensive surgical staging.