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Increase in post-therapy tumor calcification on CT scan is not an indicator of response to therapy in low-grade serous ovarian cancer

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Abstract

Purpose

The aim of the study was to determine if increasing post-therapy calcification in peritoneal metastases in recurrent low-grade serous ovarian carcinomas indicated response to therapy.

Materials and methods

Retrospective analysis of patients with histologically confirmed, recurrent low-grade serous ovarian carcinoma who received treatment at our institution between 2000 and 2014 was performed. Only patients who had calcified tumor implants and showed either interval increase or decrease in tumor calcification following therapy were included in the study. Pre- and post-therapy CT scans of these patients were reviewed by 2 radiologists independently. Changes in the tumor calcification status and tumor deposits size were correlated with serum CA-125 levels. Fisher’s exact test was used to assess the association between peritoneal deposit and calcification status with serum CA-125 status.

Results

35 Patients were included in the study. Based on serial serum CA 125 levels, 22 patients (63%) had progressive disease, 12 (34%) had partial response and 1 (3%) had stable disease. Using RECIST 1.1, 16 had progressive disease, 3 had partial response and 16 had stable disease. In the patients with progressive disease, post-therapy tumor calcification increased in 77% and decreased in 23%. Fischer’s exact test showed that serum CA 125 change was significantly associated with change in size of peritoneal deposits and calcification change.

Conclusions

This preliminary study shows that post-therapy increase in peritoneal implant calcification in low-grade serous ovarian carcinomas is not an indicator of response to therapy.

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Acknowledgments

This study was supported by MD Anderson Cancer Center Support Grant No. NIH/NCI P30 CA016672 from the National Cancer Institute, National Institutes of Health.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA

    Dhakshinamoorthy Ganeshan, Priya Bhosale, Eniola Mudasiru-Dawodu & Revathy Iyer

  2. Department of Biostatistics, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030-4009, USA

    Wei Wei

  3. Department of Pathology, University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler Street, Unit 1473, Houston, TX, 77030-4009, USA

    Preetha Ramalingam

  4. Department of Gynecologic Oncology & Reproductive Medicine, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030-4009, USA

    David Gershenson & Charlotte Sun

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  1. Dhakshinamoorthy Ganeshan
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  2. Priya Bhosale
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  3. Wei Wei
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Correspondence to Dhakshinamoorthy Ganeshan.

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Conflict of interest

All authors confirm that there are no relevant conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Being a retrospective study, formal consent was not required. This article does not contain any studies with animals performed by any of the authors.

Informed consent

IRB approval was obtained for a waiver of Informed Consent/Authorization because this is a retrospective chart review that involves no diagnostic or therapeutic intervention, as well as no direct patient contact and no patient identifiers. A consent waiver was granted by the institutional review board.

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Ganeshan, D., Bhosale, P., Wei, W. et al. Increase in post-therapy tumor calcification on CT scan is not an indicator of response to therapy in low-grade serous ovarian cancer. Abdom Radiol 41, 1589–1595 (2016). https://doi.org/10.1007/s00261-016-0701-3

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  • DOI: https://doi.org/10.1007/s00261-016-0701-3

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