Introduction/Background* comparative study between laparascopic scoring and laparatomy scoring in patient with advanced ovarian cancer

Methodology This prospective study conducted between march2020 and march2021. Participant in the study were 27 patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated to Isfahan University of Medical Science. Predictive index value (PIV) score (range: 0–14) was calculated for all patients. Patients with PIV scores <8 were offered primary cytoreductive surgery and those with score ≥8 received NACT)neoadjuvant chemotherapy). Patients who underwent primary cytoreductive surgery received a second PIV score at the time of their laparotomy and concordance between two PIV scores were calculated. All patients had primary surgery at the same day as laparoscopy. Residual disease following primary cytoreductive surgery was documented for each patient. PPV was used to determine the ability of the PIV score at laparoscopy to predict R0 at primary cytoreductive surgery.

Result(s)*27 patients underwent laparoscopic scoring, 25patient (92/5%) had a PIV score <8 and 2 (7/5%) had a PIV score ≥8. There was overall 92% concordance between PIV scores at laparoscopy and laparotomy. Concordance scores by location were: bowel infiltration 76%, mesenteric disease 92%, liver surface involvement 96%, omental disease92%, diaphragm disease 96%, stomach infiltration 100%, peritoneal carcinomatosis 96%. A laparoscopic PIV score of <8 had a PPV of 92% at predicting R0 at primary cytoreductive surgery.

Conclusion*Laparoscopic scoring allowed for a more personalized approach to the management of patients with advanced-stage ovarian cancer at our institution. It resulted in an objective triage of patients to primary cytoreduction or NACT, and improved R0 resection rates at primary cytoreductive surgery. This study hasdescribed select the patients that would achieve the most benefit from primary surgery.

Laparoscopic scoring allowed for a more personalized approach to the management of patients with advanced-stage ovarian cancer at our institution. It resulted in an objective triage of patients to primary cytoreduction or NACT, and improved R0 resection rates at primary cytoreductive surgery. The present study has designed to assess the patients that would experience the maximum benefits from primary surgery.