title: A multicentric trial (Olympia-MITO 13) on the accuracy of laparoscopy to assess peritoneal spread in ovarian cancer.
abstract: OBJECTIVE
  The objective of the study was to prospectively evaluate the accuracy of laparoscopy performed in satellite centers (SCs) to describe intraabdominal diffusion of advanced ovarian cancer (AOC).
  
  
  METHODS
  Patients with a clinical/radiological suspicion of AOC were included in the protocol. SCs were selected among those surgeons, spending a short intensive training period at the coordinator center (CC) to learn the application of staging laparoscopy (S-LPS) in AOC. All women underwent S-LPS at the SCs, and the surgical procedure was recorded and blindly reviewed at the CC. Calculating specificity, positive and negative predictive values, and the accuracy for each parameter with respect to the CC assessed the diagnostic performance of S-LPS. The Cohen's kappa was used to test the interobserver agreement of each parameter.
  
  
  RESULTS
  One hundred sixty-eight cases were considered eligible for the study. A per-protocol analysis was performed on 120 cases. The worst laparoscopic assessable feature was mesenteric retraction, whereas the remaining variables ranged from 99.2% (peritoneal carcinomatosis) to 90% (bowel infiltration). All but 1 SC (SC number 4) reached an accuracy rate of 80% or greater for both single parameters and overall score. The Cohen's kappa and the P value for overall predicitive index value were 0.685 and .01, respectively, but improved to 0.773 and .388 after removing the SC number 4 from the analysis.
  
  
  CONCLUSIONS
  S-LPS allows an accurate and reliable assessment of intraperitoneal diffusion of disease in AOC patients in trained gynecological oncology centers.
authors.affiliation: Division of Minimally Invasive Gynecological Surgery, Department of Surgery, St. Maria Hospital, University of Perugia, Terni, Italy. Electronic address: annafagotti@libero.it.
authors.forename: Anna
authors.initials: A
authors.lastname: Fagotti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vizzielli
authors.forename: Pierandrea
authors.initials: P
authors.lastname: De Iaco
authors.forename: Daniela
authors.initials: D
authors.lastname: Surico
authors.forename: Alessandro
authors.initials: A
authors.lastname: Buda
authors.forename: Vincenzo Dario
authors.initials: VD
authors.lastname: Mandato
authors.forename: Francesco
authors.initials: F
authors.lastname: Petruzzelli
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Garzarelli
authors.forename: Liliana
authors.initials: L
authors.lastname: Mereu
authors.forename: Riccardo
authors.initials: R
authors.lastname: Viganò
authors.forename: Saverio
authors.initials: S
authors.lastname: Tateo
authors.forename: Francesco
authors.initials: F
authors.lastname: Fanfani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
keywords: accuracy; carcinomatosis; laparoscopy; ovarian cancer; specificity