title: Is complete cytoreductive surgery feasible in this patient with ovarian cancer?
abstract: BACKGROUND
  Post-operative residual tumor size is the main prognostic factor in advanced epithelial ovarian cancer. Our objective was to develop a score for predicting the feasibility of complete cytoreductive surgery in patients with advanced epithelial ovarian cancer.
  
  
  METHODS
  Using data from a retrospective cohort of 123 patients with advanced ovarian cancer, we developed a score for predicting complete cytoreductive surgery, by performing multiple logistic regression after a jackknife procedure.
  
  
  RESULTS
  Three criteria were independently associated with incomplete cytoreductive surgery confirmed by surgery: age >60 years (adjusted odds ratio [aOR], 6.37; 95% confidence interval [95%CI], 1.9-21.3), diaphragmatic carcinomatosis by computed tomography (aOR, 3.34; 95%CI, 1.1-9.9), and a Peritoneal Cancer Index >10 by diagnostic laparoscopy (aOR, 3.8; 95%CI, 1.4-10.2). A 10-point score was developed based on these three criteria. The area-under-the-curve of the score was 0.76 (95%CI, 0.67-0.86). The score discriminated between groups with low and high risks of incomplete cytoreductive surgery (4.4% [95% CI, 0-10.5] and 42.9% [95% CI, 26.3-59.4], respectively). Using a cutoff of 4, sensitivity of the score was 92.8% (95%CI, 83.2-100) and specificity was 77% (95%CI, 67.1-84.9) for predicting incomplete cytoreductive surgery.
  
  
  CONCLUSIONS
  This easy-to-calculate score may prove useful to identify patients with ovarian peritoneal carcinomatosis in whom complete cytoreductive surgery is feasible.
authors: Gynecologic Oncology Centre Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France.
authors: Anne-Lucie
authors: AL
authors: Dessapt
authors: Department of Gynecology and Obstetrics, CHI Poissy-Saint-Germain, 10 rue du Champ Gaillard, 78300, Poissy, France; EA 7285 Clinical Risks and Safety on Women's Health, University Versailles-Saint-Quentin en Yvelines, 2 Avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France. Electronic address: cyrillehuchon@yahoo.fr.
authors: Cyrille
authors: C
authors: Huchon
authors: Gynecologic Oncology Centre Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors: Charlotte
authors: C
authors: Ngo
authors: Gynecologic Oncology Centre Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; INSERM UMR S 1124, Faculté de Médecine, Université Paris Descartes, Paris, France.
authors: Anne-Sophie
authors: AS
authors: Bats
authors: Gynecologic Oncology Centre Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France.
authors: Chérazade
authors: C
authors: Bensaid
authors: Gynecologic Oncology Centre Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; INSERM UMR S 1124, Faculté de Médecine, Université Paris Descartes, Paris, France.
authors: Fabrice
authors: F
authors: Lecuru
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000473:pathology / Q000601:surgery*; D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery*; D000368:Aged; D018284:Cystadenocarcinoma, Serous / Q000473:pathology / Q000601:surgery*; D065426:Cytoreduction Surgical Procedures; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies
keywords: Cytoreductive surgery; Ovarian cancer; Predictive score