Correlation of pre-operative CT findings with surgical & histological tumor dissemination patterns at cytoreduction for primary advanced and relapsed epithelial ovarian cancer: A retrospective evaluation.

OBJECTIVES: Computed tomography (CT) is an essential part of preoperative planning prior to cytoreductive surgery for primary and relapsed epithelial ovarian cancer (EOC). Our aim is to correlate pre-operative CT results with intraoperative surgical and histopathological findings at debulking surgery. METHODS: We performed a systematic comparison of intraoperative tumor dissemination patterns and surgical resections with preoperative CT assessments of infiltrative disease at key resection sites, in women who underwent multivisceral debulking surgery due to EOC between January 2013 and December 2014 at a tertiary referral center. The key sites were defined as follows: diaphragmatic involvement(DI), splenic disease (SI), large (LBI) and small (SBI) bowel involvement, rectal involvement (RI), porta hepatis involvement (PHI), mesenteric disease (MI) and lymph node involvement (LNI). RESULTS: A total of 155 patients, mostly with FIGO stage IIIC disease (65%) were evaluated (primary=105, relapsed=50). Total macroscopic cytoreduction rates were: 89%. Pre-operative CT findings displayed high specificity across all tumor sites apart from the retroperitoneal lymph node status, with a specificity of 65%. The ability however of the CT to accurately identify sites affected by invasive disease was relatively low with the following sensitivities as relating to final histology: 32% (DI), 26% (SI), 46% (LBI), 44% (SBI), 39% (RI), 57% (PHI), 31% (MI), 63% (LNI). CONCLUSION: Pre-operative CT imaging shows high specificity but low sensitivity in detecting tumor involvement at key sites in ovarian cancer surgery. CT findings alone should not be used for surgical decision making.

Effects of three amendments on extractability and fractionation of Pb, Cu, Ni and Sb in two shooting range soils.

Contamination of shooting range soils with toxic trace elements, in particular Pb and Sb, is of increasing environmental concern worldwide. We studied the extractability of Sb, and other metals in two shooting range soils: a calcareous soil (pH 8) with low organic carbon (0.5%) and a non-calcareous soil (pH 6.3) with elevated organic carbon content (5%). Both soils contained total concentrations of around 500 mg kg(-1) Pb, 65 mg kg(-1) Cu, 100 mg kg(-1) Zn and 20 mg kg(-1) Sb. We tested the effects of Ca(OH)(2), phosphate and sodium humate amendments on metals and Sb extractability. Extracts with H(2)O and NaNO(3) contained 0.02-0.05% of the total Zn and Pb; 0.1-0.5% of total Ni and Cu and approximately 1% of total Sb. Sequential extraction procedure of Zeien and Brümmer resulted in similar percentages for the sum of the two most labile fractions (F1+F2) in two soils: 10% Pb, and 15-20% Sb. Water and NaNO(3)-extractable Sb concentrations increased after phosphate addition, but were not affected by the addition of sodium humate. The results show that leaching of Sb from shooting ranges into ground and surface waters may generate a serious environmental risk under widely different soils conditions.