Acta obstetricia et gynecologica Scandinavica · 2011
Learning curve and pitfalls of a laparoscopic score to describe peritoneal carcinosis in advanced ovarian cancer.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Fagotti Anna, Vizzielli Giuseppe, Costantini Barbara, Lecca Antonella, Gallotta Valerio, Gagliardi Maria Lucia, Scambia Giovanni, Fanfani Francesco
Аннотация
OBJECTIVE: To prospectively estimate the agreement between a fellow in training in gynecologic oncology and a senior surgeon performing a laparoscopic score to describe peritoneal carcinosis diffusion in patients with advanced ovarian cancer.
DESIGN: Single-institutional non-inferiority trial.
SETTING: University hospital tertiary care center.
POPULATION: Ninety consecutive patients with primary advanced ovarian cancer.
METHODS: The patients underwent staging-laparoscopy by a fellow in gynecologic oncology and a senior surgeon, sequentially and blindly. Single laparoscopic parameters (omental cake, peritoneal and diaphragmatic carcinosis, mesenteric retraction, bowel stomach infiltration, superficial liver metastasis) and a comprehensive laparoscopic score (PIV) were assessed in each procedure and registered.
MAIN OUTCOME MEASURES: No differences in the score discriminating performance for predicting optimal cytoreduction were observed between fellows' and seniors' evaluations.
RESULTS: The median number of staging laparoscopies performed by each fellow was 30 (range 28-32). The median score was 6 (0-10) for the fellows and 6 (0-14) for senior surgeons (p=ns). Results were superimposable in 57 of 90 patients (63.3%). Dividing the study period into two blocks, cases 1-45 and cases 46-90, differences were equally distributed over time (16.6 vs. 20%; p=0.9). The area under the curve of the receiver operating characteristic (ROC) curves for the score of fellows and seniors was 0.86 and 0.89, respectively (p=ns).
CONCLUSIONS: The laparoscopic assessment of peritoneal cancer diffusion according to a laparoscopic score can reliably be carried out by a fellow in gynecologic oncology after 12 months' experience without significant differences from a senior surgeon's assessment.
DESIGN: Single-institutional non-inferiority trial.
SETTING: University hospital tertiary care center.
POPULATION: Ninety consecutive patients with primary advanced ovarian cancer.
METHODS: The patients underwent staging-laparoscopy by a fellow in gynecologic oncology and a senior surgeon, sequentially and blindly. Single laparoscopic parameters (omental cake, peritoneal and diaphragmatic carcinosis, mesenteric retraction, bowel stomach infiltration, superficial liver metastasis) and a comprehensive laparoscopic score (PIV) were assessed in each procedure and registered.
MAIN OUTCOME MEASURES: No differences in the score discriminating performance for predicting optimal cytoreduction were observed between fellows' and seniors' evaluations.
RESULTS: The median number of staging laparoscopies performed by each fellow was 30 (range 28-32). The median score was 6 (0-10) for the fellows and 6 (0-14) for senior surgeons (p=ns). Results were superimposable in 57 of 90 patients (63.3%). Dividing the study period into two blocks, cases 1-45 and cases 46-90, differences were equally distributed over time (16.6 vs. 20%; p=0.9). The area under the curve of the receiver operating characteristic (ROC) curves for the score of fellows and seniors was 0.86 and 0.89, respectively (p=ns).
CONCLUSIONS: The laparoscopic assessment of peritoneal cancer diffusion according to a laparoscopic score can reliably be carried out by a fellow in gynecologic oncology after 12 months' experience without significant differences from a senior surgeon's assessment.
Предметные рубрики MeSH
AdultAgedAged, 80 and overClinical CompetenceCohort StudiesConfidence IntervalsFemaleFollow-Up StudiesGynecologyHospitals, UniversityHumansInternship and ResidencyLaparoscopyLearning CurveMedical Staff, HospitalMiddle AgedNeoplasm InvasivenessNeoplasm StagingOvarian NeoplasmsPeritoneal NeoplasmsProspective StudiesROC CurveRisk AssessmentTreatment Outcome