title: A comparative analysis of prediction models for complete gross resection in secondary cytoreductive surgery for ovarian cancer.
abstract: We sought to examine compliance and outcomes using Memorial Sloan Kettering "(MSK) criteria" to predict complete gross resection (CGR) and compare them with the validated Tian and AGO models.
  
  
  
  Patients who underwent SCS for recurrent platinum-sensitive ovarian cancer from 5/2001-6/2014 were identified. The AGO and Tian models were applied to the study population; appropriate statistical tests were used to determine ability to predict CGR.
  
  
  
  214 SCS cases were identified. Since the implementation of MSK criteria, the CGR rate has been 86%. The AGO model had a 49% accuracy rate in predicting CGR, and predicted gross residual disease (RD) in 51%; however, CGR was achieved in 86%. The Tian model had an 88% accuracy rate. Of the 4% scored as Tian high risk for gross RD, 33% achieved a CGR. Comparing models, McNemar's p-value was 0.366 between the Tian and MSK models and <0.001 between AGO and MSK criteria. Median PFS was 21.3 (95%CI, 18.2-24.5), 22.5 (95%CI, 19.4-25.3), and 14.1months (95%CI, 9.7-22.1) for the entire cohort, for those achieving CGR, and for those left with RD, respectively (p=0.013). OS was 82.2 (95%CI, 60.2-123.3), 95.6 (95%CI, 63.6-NE), and 57.5months (95%CI, 27.5-113.9), respectively (p=0.014).
  
  
  
  CGR during SCS is associated with extended PFS and OS. We report a high rate of CGR using MSK criteria. There was good concordance between the Tian and MSK models; however, the latter has fewer variables and is more user-friendly. Tian criteria may be applied to intermediate MSK cases for further stratification.
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
authors.forename: Renee A
authors.initials: RA
authors.lastname: Cowan
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
authors.forename: Ane Gerda Zahl
authors.initials: AGZ
authors.lastname: Eriksson
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Jaber
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
authors.forename: Alexia
authors.initials: A
authors.lastname: Iasonos
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, United States.
authors.forename: Oliver
authors.initials: O
authors.lastname: Zivanovic
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, United States.
authors.forename: Mario M
authors.initials: MM
authors.lastname: Leitao
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, United States.
authors.forename: Nadeem R
authors.initials: NR
authors.lastname: Abu-Rustum
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, United States.
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Chi
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, United States. Electronic address: gardnerg@mskcc.org.
authors.forename: Ginger J
authors.initials: GJ
authors.lastname: Gardner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077216:Carcinoma, Ovarian Epithelial; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D015233:Models, Statistical; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult
keywords: AGO DESKTOP criteria; Complete gross resection; Ovarian cancer; Prediction models; Secondary cytoreductive surgery; Tian model