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39 Development of a nomogram to predict interval debulking surgery feasibility when primary cytoreduction is not an option
  1. A Rosati1,
  2. C Marchetti1,
  3. F DeFelice2,
  4. V Tranquillo3,
  5. V Iacobelli1,
  6. L Quagliozzi1,
  7. V Salutari1,
  8. G Scambia4 and
  9. A Fagotti4
  1. 1Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Italy
  2. 2Division of Radiotherapy and Oncology, Policlinico Umberto I,Università La Sapienza, Italy
  3. 3Università Cattolica del Sacro Cuore, Italy
  4. 4Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS,Università Cattolica del Sacro Cuore, Italy


Introduction Neoadjuvant chemotherapy (NACT) and subsequent interval debulking surgery (IDS) has been proposed as an alternative to primary debulking surgery in advanced epithelial ovarian carcinoma. However, no biomarkers of NACT efficacy are reliable in predicting chemo response. This study aimed to identify pre-operative factors of IDS success probability.

Methods Single institution, retrospective study. Preoperative variables were used to predict the likelihood of IDS using multivariable models. A nomogram was developed and internal validation was performed.

Results 359 women were submitted to NACT between January 2016 and June 2019.

A complete cytoreductive surgery was achieved in 255 (85%) patients, while an optimal/suboptimal cytoreduction was reached in the remaining 46 (15%) and 58 (16%) did not undergo surgery after NACT. Women with BRCA 1/2 mutation (OR 4.84, CI 95% 1.75—13.34; p= 0.002) and lower tumour load (OR 8.15, CI 95%1.06–62.32; p= 0.043) were more likely to undergo IDS. Among patients who did not undergo IDS, only 5 (13%) presented with BRCA 1/2 mutation, compared with 34 (87%) wild type BRCA (p<0.001). According to the predictive model, we constructed a nomogram to report the probability of IDS using five variables: age, Charlson-comorbidity category, histology, LPS-PIV and BRCA-status (figure 1). The calibration plot demonstrated good agreement between predicted and actual probability of surgical treatment (figure 2).

Abstract 39 Figure 1

Nomogram predicting surgery probability in patients with ovarian cancer

Abstract 39 Figure 2

Calibration plot of the nomogram

Conclusions This is the first nomogram developed in this setting and it might help physicians with their decision-making algorithm.

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