A predictive score for optimal cytoreduction at interval debulking surgery in epithelial ovarian cancer: a two- centers experience
Abstract Background Optimal cytoreduction (macroscopic Residual Tumor, RT = 0) is the best survival predictor factor in epithelial ovarian cancer (EOC). It doesn’t exist a consolidated criteria to predict optimal surgical resection at interval debulking surgery (IDS). The aim of this study is to dev...
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doaj-27c694ec78e94f578a25914277c407722020-11-24T22:17:21ZengBMCJournal of Ovarian Research1757-22152018-05-011111710.1186/s13048-018-0415-yA predictive score for optimal cytoreduction at interval debulking surgery in epithelial ovarian cancer: a two- centers experienceEleonora Ghisoni0Dionyssios Katsaros1Furio Maggiorotto2Massimo Aglietta3Marco Vaira4Michele De Simone5Gloria Mittica6Gaia Giannone7Manuela Robella8Sofia Genta9Fabiola Lucchino10Francesco Marocco11Fulvio Borella12Giorgio Valabrega13Riccardo Ponzone14Candiolo Cancer Institute FPO-IRCCSDepartment of Surgical Sciences, Gynecology, AOU, Città della Salute e della ScienzaCandiolo Cancer Institute FPO-IRCCSCandiolo Cancer Institute FPO-IRCCSCandiolo Cancer Institute FPO-IRCCSCandiolo Cancer Institute FPO-IRCCSCandiolo Cancer Institute FPO-IRCCSCandiolo Cancer Institute FPO-IRCCSCandiolo Cancer Institute FPO-IRCCSCandiolo Cancer Institute FPO-IRCCSDepartment of Surgical Sciences, Gynecology, AOU, Città della Salute e della ScienzaCandiolo Cancer Institute FPO-IRCCSDepartment of Surgical Sciences, Gynecology, AOU, Città della Salute e della ScienzaCandiolo Cancer Institute FPO-IRCCSCandiolo Cancer Institute FPO-IRCCSAbstract Background Optimal cytoreduction (macroscopic Residual Tumor, RT = 0) is the best survival predictor factor in epithelial ovarian cancer (EOC). It doesn’t exist a consolidated criteria to predict optimal surgical resection at interval debulking surgery (IDS). The aim of this study is to develop a predictive model of complete cytoreduction at IDS. Methods We, retrospectively, analyzed 93 out of 432 patients, with advanced EOC, underwent neoadjuvant chemotherapy (NACT) and IDS from January 2010 to December 2016 in two referral cancer centers. The correlation between clinical-pathological variables and residual disease at IDS has been investigated with univariate and multivariate analysis. A predictive score of cytoreduction (PSC) has been created by combining all significant variables. The performance of each single variable and PSC has been reported and the correlation of all significant variables with progression free survival (PFS) has been assessed. Results At IDS, 65 patients (69,8%) had complete cytoreduction with no residual disease (R = 0). Three criteria independently predicted R > 0: age ≥ 60 years (p = 0.014), CA-125 before NACT > 550 UI/dl (p = 0.044), and Peritoneal Cancer Index (PCI) > 16 (p < 0.001). A PSC ≥ 3 has been associated with a better accuracy (85,8%), limiting the number of incomplete surgeries to 16,5%. Moreover, a PCI > 16, a PSC ≥ 3 and the presence of R > 0 after IDS were all significantly associated with shorter PFS (p < 0.001, p < 0.001 and p = 0.004 respectively). Conclusions Our PSC predicts, in a large number of patients, complete cytoreduction at IDS, limiting the rate of futile extensive surgeries in case of presence of residual tumor (R > 0). The PSC should be prospectively validated in a larger series of EOC patients undergoing NACT-IDS.http://link.springer.com/article/10.1186/s13048-018-0415-yOvarian cancerInterval debulking surgeryOptimal cytoreductionPredictive scorePeritoneal cancer index |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Eleonora Ghisoni Dionyssios Katsaros Furio Maggiorotto Massimo Aglietta Marco Vaira Michele De Simone Gloria Mittica Gaia Giannone Manuela Robella Sofia Genta Fabiola Lucchino Francesco Marocco Fulvio Borella Giorgio Valabrega Riccardo Ponzone |
spellingShingle |
Eleonora Ghisoni Dionyssios Katsaros Furio Maggiorotto Massimo Aglietta Marco Vaira Michele De Simone Gloria Mittica Gaia Giannone Manuela Robella Sofia Genta Fabiola Lucchino Francesco Marocco Fulvio Borella Giorgio Valabrega Riccardo Ponzone A predictive score for optimal cytoreduction at interval debulking surgery in epithelial ovarian cancer: a two- centers experience Journal of Ovarian Research Ovarian cancer Interval debulking surgery Optimal cytoreduction Predictive score Peritoneal cancer index |
author_facet |
Eleonora Ghisoni Dionyssios Katsaros Furio Maggiorotto Massimo Aglietta Marco Vaira Michele De Simone Gloria Mittica Gaia Giannone Manuela Robella Sofia Genta Fabiola Lucchino Francesco Marocco Fulvio Borella Giorgio Valabrega Riccardo Ponzone |
author_sort |
Eleonora Ghisoni |
title |
A predictive score for optimal cytoreduction at interval debulking surgery in epithelial ovarian cancer: a two- centers experience |
title_short |
A predictive score for optimal cytoreduction at interval debulking surgery in epithelial ovarian cancer: a two- centers experience |
title_full |
A predictive score for optimal cytoreduction at interval debulking surgery in epithelial ovarian cancer: a two- centers experience |
title_fullStr |
A predictive score for optimal cytoreduction at interval debulking surgery in epithelial ovarian cancer: a two- centers experience |
title_full_unstemmed |
A predictive score for optimal cytoreduction at interval debulking surgery in epithelial ovarian cancer: a two- centers experience |
title_sort |
predictive score for optimal cytoreduction at interval debulking surgery in epithelial ovarian cancer: a two- centers experience |
publisher |
BMC |
series |
Journal of Ovarian Research |
issn |
1757-2215 |
publishDate |
2018-05-01 |
description |
Abstract Background Optimal cytoreduction (macroscopic Residual Tumor, RT = 0) is the best survival predictor factor in epithelial ovarian cancer (EOC). It doesn’t exist a consolidated criteria to predict optimal surgical resection at interval debulking surgery (IDS). The aim of this study is to develop a predictive model of complete cytoreduction at IDS. Methods We, retrospectively, analyzed 93 out of 432 patients, with advanced EOC, underwent neoadjuvant chemotherapy (NACT) and IDS from January 2010 to December 2016 in two referral cancer centers. The correlation between clinical-pathological variables and residual disease at IDS has been investigated with univariate and multivariate analysis. A predictive score of cytoreduction (PSC) has been created by combining all significant variables. The performance of each single variable and PSC has been reported and the correlation of all significant variables with progression free survival (PFS) has been assessed. Results At IDS, 65 patients (69,8%) had complete cytoreduction with no residual disease (R = 0). Three criteria independently predicted R > 0: age ≥ 60 years (p = 0.014), CA-125 before NACT > 550 UI/dl (p = 0.044), and Peritoneal Cancer Index (PCI) > 16 (p < 0.001). A PSC ≥ 3 has been associated with a better accuracy (85,8%), limiting the number of incomplete surgeries to 16,5%. Moreover, a PCI > 16, a PSC ≥ 3 and the presence of R > 0 after IDS were all significantly associated with shorter PFS (p < 0.001, p < 0.001 and p = 0.004 respectively). Conclusions Our PSC predicts, in a large number of patients, complete cytoreduction at IDS, limiting the rate of futile extensive surgeries in case of presence of residual tumor (R > 0). The PSC should be prospectively validated in a larger series of EOC patients undergoing NACT-IDS. |
topic |
Ovarian cancer Interval debulking surgery Optimal cytoreduction Predictive score Peritoneal cancer index |
url |
http://link.springer.com/article/10.1186/s13048-018-0415-y |
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