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Computed Tomography Features Vary Based on BRCA Status

THURSDAY, Oct. 31, 2017 -- Qualitative computed tomography (CT) features differ between patients with BRCA-mutant high-grade serous ovarian cancer (HGSOC) and patients with BRCA wild-type HGSOC, according to a study published in the November issue of Radiology.

Stephanie Nougaret, M.D., Ph.D., from Memorial Sloan-Kettering Cancer Center in New York City, and colleagues evaluated associations between CT features, BRCA mutation status, cytoreductive outcome, and progression-free survival (PFS) among 108 patients with HGSOC (33 with BRCA-mutant and 75 with BRCA wild-type HGSOC) who underwent CT before primary debulking.

The researchers found that peritoneal disease (PD) pattern, presence of PD in gastrohepatic ligament, mesenteric involvement, and supradiaphragmatic lymphadenopathy at CT were associated with BRCA mutation status. Clinical and CT features were not associated with cytoreductive outcome for patients with BRCA-mutant HGSOC. However, in BRCA wild-type HGSOC, presence of PD in lesser sac (odds ratio [OR], 2.4) and left upper quadrant (OR, 1.19), mesenteric involvement (OR, 7.1), and lymphadenopathy in supradiaphragmatic (OR, 2.83) and suprarenal para-aortic (OR, 4.79) regions were associated with higher odds of incomplete cytoreduction. There was a significantly shorter PFS associated with mesenteric involvement at CT for both patients with BRCA-mutant HGSOC (hazard ratio [HR], 26.7) and those with BRCA wild-type HGSOC (reader 1: HR, 2.42; reader 2: HR, 2.61).

"This information may be of value for pretreatment patient counseling and initial decision making regarding maximal upfront cytoreductive effort versus neoadjuvant chemotherapy," write the authors.

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Posted: October 2017