@article{DuhrKennKickuthetal.2011, author = {Duhr, Carolin D. and Kenn, Werner and Kickuth, Ralph and Kerscher, Alexander G. and Germer, Christoph-Thomas and Hahn, Dietbert and Pelz, Joerg O. W.}, title = {Optimizing of preoperative computed tomography for diagnosis in patients with peritoneal carcinomatosis}, series = {World Journal of Surgical Oncology}, volume = {9}, journal = {World Journal of Surgical Oncology}, number = {171}, doi = {10.1186/1477-7819-9-171}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-138024}, year = {2011}, abstract = {Background and Objective This study evaluates whether Computer Tomography is an effective procedure for preoperative staging of patients with Peritoneal Carcinomatosis. Method A sample of 37 patients was analyzed with contrast enhanced abdominal Computer Tomography, followed by surgical staging. All Computer Tomography scans were evaluated 3 times by 2 radiologists with one radiologist reviewing 2 times. The efficacy of Computer Tomography was evaluated using the Spearman correlation coefficient. Correlations were analyzed by abdominopelvic region to assess results of the Peritoneal Carcinomatosis Index (PCI) aggregating the 13 regions. Surgical findings were compared to radiological findings. Results Results indicate high correlations between the surgical and radiological Peritoneal Carcinomatosis Indices. Analyses of the intra-class correlation between the first and second reading of one radiologist suggest high intra-observer reliability. Correlations by abdominopelvic region show higher values in the upper and middle regions and relatively lower values in the lower regions and the small bowel (correlation coefficients range between 0.418 and 0.726, p < 0.010; sensitivities range between 50\% and 96\%; and specificities range between 62\% and 100\%). Conclusion Computer Tomography represents an effective procedure in the preoperative staging of patients with PC. However, results by abdominopelvic region show lower correlation, therefore suggest lower efficacy. These results are supported by analyses of sensitivity and accuracy by lesion size. This suggests that Computer Tomography is an effective procedure for pre-operative staging but less for determining a tumor's accurate extent.}, language = {en} } @article{PelzChuaEsquiveletal.2010, author = {Pelz, Joerg O. W. and Chua, Terence C. and Esquivel, Jesus and Stojadinovic, Alexander and Doerfer, Joerg and Morris, David L. and Maeder, Uwe and Germer, Christoph-Thomas and Kerscher, Alexander G.}, title = {Evaluation of Best Supportive Care and Systemic Chemotherapy as Treatment Stratified according to the retrospective Peritoneal Surface Disease Severity Score (PSDSS) for Peritoneal Carcinomatosis of Colorectal Origin}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-67875}, year = {2010}, abstract = {Background: We evaluate the long-term survival of patients with peritoneal carcinomatosis (PC) treated with systemic chemotherapy regimens, and the impact of the of the retrospective peritoneal disease severity score (PSDSS) on outcomes. Methods: One hundred sixty-seven consecutive patients treated with PC from colorectal cancer between years 1987-2006 were identified from a prospective institutional database. These patients either received no chemotherapy, 5-FU/Leucovorin or Oxaliplatin/Irinotecan-based chemotherapy. Stratification was made according to the retrospective PSDSS that classifies PC patients based on clinically relevant factors. Survival analysis was performed using the Kaplan-Meier method and comparison with the log-rank test. Results: Median survival was 5 months (95\% CI, 3-7 months) for patients who had no chemotherapy, 11 months (95\% CI, 6-9 months) for patients treated with 5 FU/LV, and 12 months (95\% CI, 4-20 months) for patients treated with Oxaliplatin/Irinotecan-based chemotherapy. Survival differed between patients treated with chemotherapy compared to those patients who did not receive chemotherapy (p = 0.026). PSDSS staging was identified as an independent predictor for survival on multivariate analysis [RR 2.8 (95\%CI 1.5-5.4); p < 0.001]. Conclusion: A trend towards improved outcomes is demonstrated from treatment of patients with PC from colorectal cancer using modern systemic chemotherapy. The PSDSS appears to be a useful tool in patient selection and prognostication in PC of colorectal origin.}, subject = {Krebs }, language = {en} }