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The Cukurova score in the prediction of primary cytoreduction in ovarian cancer
  1. Ghanim Khatib1,
  2. Sevtap Seyfettinoglu2,
  3. Sevgul Kose3,
  4. Umran Kucukgoz Gulec4,
  5. Alper Avcı5,
  6. Ahmet Baris Güzel1,
  7. İlker Ünal6,
  8. Semra Paydas7 and
  9. Mehmet Ali Vardar1
  1. 1 Gynecologic Oncology, Cukurova University Faculty of Medicine, Adana, Turkey
  2. 2 Gynecologic Oncology, Ministry of Health Adana City Training & Research Hospital, Adana, Turkey
  3. 3 Radiology, Cukurova University Faculty of Medicine, Adana, Turkey
  4. 4 Gynecologic Oncology, Cukurova University School of Medicine, Adana, Turkey
  5. 5 Thoracic Surgery, Cukurova University Faculty of Medicine, Adana, Turkey
  6. 6 Biostatistics, Cukurova University Faculty of Medicine, Adana, Turkey
  7. 7 Department of Medical Oncology, Cukurova University, Adana, Turkey
  1. Correspondence to Dr Ghanim Khatib, gynecologic oncology, Cukurova University Faculty of Medicine, Adana 01330, Turkey; ghanim.khatib{at}


Objective Primary debulking surgery has been the preferred surgical route and is still considered a quality indicator for advanced ovarian cancer surgery. However, a significant number of patients are not amenable to upfront surgery. Neoadjuvant chemotherapy and interval debulking surgery may be the most suitable approach for this group. This study aimed to evaluate a novel score for prediction of the cytoreduction results at primary debulking surgery for ovarian cancer patients.

Methods This observational prospective study was conducted at a tertiary gynecologic oncology center between December 2020 and August 2022. Presumed primary stage III-IV epithelial ovarian carcinoma cases were included. Borderline tumors, and metastatic or non-epithelial ovarian malignancies, were excluded. Based on imaging findings, points were assigned to each anticipated surgical procedure required for complete cytoreduction. The sum of these points was multiplied by the patient’s Eastern Cooperative Oncology Group (ECOG) score, and thus, the Cukurova-clinic score was established. Furthermore, the required surgical procedures based on laparoscopic evaluation were recorded, and the score was readjusted and calculated to obtain the Cukurova score.

Results One hundred and fourteen patients were included in the study. Primary debulking surgery was performed in 70% of cases. Among them, complete cytoreduction (Cukurova score ≤12) was obtained in 97.3% of cases. Complete cytoreduction was not achieved in cases with Cukurova score >12. The odds ratio of 90-day mortality was 13.4 for patients with Cukurova score >12, compared with those with Cukurova score ≤12.

Conclusion The Cukurova score is a model for classifying advanced ovarian cancer patients who may be candidates for primary debulking surgery.

  • Cytoreduction surgical procedures
  • Ovarian Cancer
  • Postoperative Period
  • Surgical Procedures, Operative

Data availability statement

Data are available upon reasonable request.

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  • Contributors Study conception and design: GK, SS, SK, ÜKG, AA, ABG, İÜ, SP, MAV. Acquisition of Data: GK, SS, SK, ÜKG, AA, ABG, İÜ, SP, MAV. Analysis and interpretation of data: GK, İÜ, MAV. Drafting of manuscript: GK, SS. Supervision: ÜKG, ABG, SP, MAV. Critical revision: all authors. Approval of the manuscript prior to submission: all authors. Guarantor: GK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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