Introduction/Background To develop an ultrasound-based score for predicting debulking surgery outcome in advanced stage ovarian cancer.
Methodology Retrospective analysis of data from a prospective cohort study comprising 65 women (mean age: 59 y.o.) with surgically confirmed stage IIB–IV epithelial ovarian cancer and ECOG status performance 0–2. All women had undergone transabdominal and transvaginal ultrasound evaluation for assessing disease spread prior to surgery. 12 anatomical areas were evaluated for the presence/absence of disease (recto-sigma involvement, carcinomatosis of pelvic peritoneum, major omentum, carcinomatosis of upper abdomen peritoneum, root of mesentery, pelvic lymph nodes, aorto-cava lymph nodes, lesser omentum, liver, spleen, hepatic hilum and ascites). All women included underwent surgery at our institution (diagnostic laparoscopy followed by upfront surgery if patient deemed adequate for optimal (R<1 cm) or complete (R0) cytoreduction). Surgical findings and permanent frozen section histologic diagnosis were used as reference standard. The score was developed according to the odd ratio (for optimal or complete cytoreduction) for each anatomical area evaluated and the value of CA-125 serum levels. (table 1).
CA-125 >500 1.
Major omentum 1.
Pelvic lymph nodes 1.
Root mesentery 2.
Liver parenchyma 2.
Spleen parenchyma 2.
Para-aortic lymph nodes 2.
Hepatic hilium 2.
Results Cytoreduction was complete or optimal in 51 patients (78.5%), suboptimal in 3 (4.6%) and upfront surgery was discarded in 11 women (16.9%). A score >3 predicted correctly 44 out 51 patients (86%) with complete/optimal cytoreduction in and 8 out of 14 (57%) of those with suboptimal or non-cytoreduction surgery. AUC was 0.76, with correct prediction in 80% of all cases.
Conclusion Albeit the series is small, the developed ultrasound-based score has a good performance for predicting surgical results in IIB–IV stage epithelial ovarian cancer.
Disclosure Nothing to disclose.
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