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KMID : 1137020180290050065
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Journal of Gynecologic Oncology
2018 Volume.29 No. 5 p.65 ~ p.65
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A triage strategy in advanced ovarian cancer management based on multiple predictive models for R0 resection: a prospective cohort study
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Feng Zheng
Wen Hao
Jiang Zhaoxia
Liu Shuai
Ju Xingzhu
Chen Xiaojun
Xia Lingfang
Xu Junyan
Bi Rui
Wu Xiaohua
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Abstract
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Objective: To present the surgical outcomes of advanced epithelial ovarian cancer (AEOC) since the implementation of a personalized approach and to validate multiple predictive models for R0 resection.
Methods: Personalized strategies included: 1) Non-invasive model: preoperative clinico-radiological assessment according to Suidan criteria with a predictive score for all individuals. Patients with a score 0?2 were recommended for primary debulking surgery (PDS, group A), or otherwise were counseled on the choices of PDS, neoadjuvant chemotherapy (NAC, group B) or staging laparoscopy (S-LPS). 2) Minimally invasive model: S-LPS with a predictive index value (PIV) according to Fagotti. Individuals with a PIV <8 underwent PDS (group C) or otherwise received NAC (group D). Intraoperative assessment (with Eisenkop, peritoneal cancer index [PCI], and Aletti scores) and surgical results were prospectively collected.
Results: Between September 2015 and August 2017, 161 pathologically confirmed epithelial ovarian cancer patients were included. A total of 52 (32.3%) patients had a predictive score of 0?2, and 109 (67.7%) patients had a score ≥3. Among these individuals, 41 (25.5%) patients received S-LPS. Finally, 110 (68.3%) patients underwent PDS (A+C), and 51 (31.7%) patients received NAC (B+D). The R0 resection rates in PDS and NAC patients were 56.4% and 60.8%, respectively. The area under the curve (AUC) of Suidan criteria was 0.548 for group (A+C). The AUC of Fagotti score was 0.702 for group C. The AUC of Eisenkop, PCI, and Aletti scores were 0.808, 0.797, and 0.524, respectively.
Conclusion: The Suidan criteria were not effective in these AEOC patients. S-LPS was helpful in decision-making for PDS and should be endorsed in the future.
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KEYWORD
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Predictive Model, Scoring Method, Surgical Outcomes, Perioperative Complications, R0 Resection, No Residual Disease
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