title: A Predictive Score for Secondary Cytoreductive Surgery in Recurrent Ovarian Cancer (SeC-Score): A Single-Centre, Controlled Study for Preoperative Patient Selection.
abstract: BACKGROUND
  The standard treatments of patients with platinum-sensitive recurrent ovarian cancer (ROC) remains poorly defined. Chemotherapy (CT) and secondary cytoreductive surgery (SCS) represent both valid options, even if several studies demonstrated a greater survival benefit, with survival rates up to 62 months, for platinum-sensitive patients undergoing complete SCS. The purpose of the present study was to develop a predictive model, named SeC-Score (SeC-s), to assess the risk of optimal SCS, including, for the first time in literature, HE4.
  
  
  METHODS
  All patients affected by suspicious ROC at radiologic imaging, referred to the Department of Gynecology of Campus Bio-medico of Rome, were prospectively included in the study. The preoperative variables considered in our predictive model were: age, residual tumour (RT) at primary cytoreduction (0 vs. >0 cm), preoperative CA125 and HE4, and ascites at recurrence. After exploratory laparotomy, patients were submitted to secondary SCS (Group A) or addressed to CT (Group B).
  
  
  RESULTS
  A total of 135 patients with ROC were considered for the analysis. Preoperative CA125, HE4, ascites, and RT at first surgery were found statistically significant and included into a multivariate logistic regression model to determine the risk to not optimal SCS. In the overall cohort of patients, SeC-s reported sensitivity and specificity of 82 and 83 %, respectively (PPV = 0.79, NPV = 0.81).
  
  
  CONCLUSIONS
  Our data support the use of SeC-s to preoperative triage patients suitable of optimal SCS, even if external validation is needed.
authors: Department of Obstetrics and Gynaecology, University of Rome "Campus Bio-Medico", Rome, Italy.
authors: Roberto
authors: R
authors: Angioli
authors: Department of Obstetrics and Gynaecology, University of Rome "Campus Bio-Medico", Rome, Italy.
authors: Stella
authors: S
authors: Capriglione
authors: Department of Obstetrics and Gynaecology, University of Rome "Campus Bio-Medico", Rome, Italy.
authors: Alessia
authors: A
authors: Aloisi
authors: Department of Obstetrics and Gynaecology, University of Rome "Campus Bio-Medico", Rome, Italy.
authors: Roberto
authors: R
authors: Ricciardi
authors: Department of Obstetrics and Gynaecology, University of Rome "Campus Bio-Medico", Rome, Italy. g.scaletta@unicampus.it.
authors: Giuseppe
authors: G
authors: Scaletta
authors: Department of Obstetrics and Gynaecology, University of Rome "Campus Bio-Medico", Rome, Italy.
authors: Salvatore
authors: S
authors: Lopez
authors: Department of Obstetrics and Gynaecology, University of Rome "Campus Bio-Medico", Rome, Italy.
authors: Andrea
authors: A
authors: Miranda
authors: Department of Obstetrics and Gynaecology, University of Rome "Campus Bio-Medico", Rome, Italy.
authors: Anna
authors: A
authors: Di Pinto
authors: Department of Obstetrics and Gynaecology, University of Rome "Campus Bio-Medico", Rome, Italy.
authors: Corrado
authors: C
authors: Terranova
authors: Department of Obstetrics and Gynaecology, University of Rome "Campus Bio-Medico", Rome, Italy.
authors: Francesco
authors: F
authors: Plotti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D000077216:Carcinoma, Ovarian Epithelial; D065426:Cytoreduction Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000097:blood / Q000473:pathology / Q000601:surgery*; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011506:Proteins / Q000378:metabolism; D012372:ROC Curve; D012107:Research Design; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human