Does the use of diagnostic PET/CT cause stage migration in patients with primary advanced ovarian cancer?

OBJECTIVE: To investigate if the use of diagnostic FDG-PET/CT leads to stage migration in patients with advanced ovarian cancer and to evaluate the prognostic significance of FDG-PET/CT. METHODS: From September 2004 to August 2007, 201 patients with a Risk of Malignancy Index (RMI) >150 based on serum CA-125, ultrasound examinations and menopausal state, underwent PET/CT within 2 weeks prior to standard surgery/debulking of a pelvic tumor. On 15 August, 2009 overall survival and prognostic variables were analysed in 66 ovarian cancer patients (64 stage III and 2 stage IV). RESULTS: Median follow-up was 30.2 months; median age was 62.5 years (range 35-85 years); 97% (64/66) had a performance status

Prediction of suboptimal primary cytoreduction in primary ovarian cancer with combined positron emission tomography/computed tomography--a prospective study.

OBJECTIVE: To prospectively identify combined PET/CT predictors of incomplete/suboptimal primary cytoreduction in advanced ovarian cancer. METHODS: From September 2004 to March 2007, 179 patients with a Risk of Malignancy Index (RMI) >150 based on serum CA-125, ultrasound examinations and menopausal state, underwent PET/CT within 2 weeks prior to standard surgery/debulking of a pelvic tumor. Ten PET/CT features were identified and evaluated as predictors of cytoreduction in 54 patients with advanced ovarian cancer. RESULTS: Complete cytoreduction (no macroscopic residual disease) was achieved in 35% and optimal cytoreduction (<1 cm residual disease) was achieved in 56%. Using univariate analysis, predictors of incomplete cytoreduction were large bowel mesentery implants (LBMI) (P<0.003), pleural effusion (P<0.009), ascites (P<0.009) and peritoneal carcinosis (P<0.01). LBMI (P<0.03) and ascites (P<0.05) were also predictors of suboptimal cytoreduction. Using multivariate analysis, LBMI was the only independent predictor of incomplete cytoreduction (P=0.004) and no predictor of suboptimal cytoreduction was found. CONCLUSION: PET/CT predictors of cytoreduction were found. But they should not be used to withhold patients form primary cytoreductive surgery. We suggest PET/CT as a supplementary image modality prior to surgery in primary OC patients whenever accurate and comprehensive preoperative evaluation of primary tumor and metastases is desired.

[Quality assurance in an open psychiatric department]. / Kvalitetssikring på åben psykiatrisk afdeling.

This prospective study regarding the quality of care and treatment on an unlocked psychiatric ward had two purposes. Firstly, to examine selected elements of care and treatment by continuously registering these elements during the patients' admission and to examine by questionnaire the patients' satisfaction with these elements at the time of their discharge. Secondly to test this method as a means of conducting quality assurance on psychiatric wards. The study took place at the Copenhagen County Hospital Herlev, Psychiatric Department Y, Denmark. Twenty-eight patients admitted to the psychiatric ward between March 1, and May 31, 1993 were included in the study and follow-up at their discharge. We found the method to be very good at uncovering strengths and weaknesses of the practices of our daily clinical work.

[Gastroscopic findings in HIV-positive patients]. / Gastroskopifund hos HIV-positive patienter.

In a retrospective study we reviewed the findings from 106 oesophago-gastro-duodenoscopies performed on HIV-positive patients between 01.01.93 and 31.12.94. Forty percent had Candida esophagei, 12% had Cytomegalovirus, 4% had atypical mycobacteria, 2% had Kaposi's sarcoma and 6% had Helicobacter pylori. Twelve percent of the patients received the diagnosis AIDS. The average CD4-cell count was 91 x 10(6)/l. The endoscopi findings were abnormal in 88% of HIV infected patients with gastrointestinal symptoms.