Introduction/Background Ovarian cancer is usually diagnosed in advanced stage. The goal of primary debulking is to achieve no residual disease (RD). Proper selection of candidates for complete debulking is crucial for the avoidance of suboptimal laparotomies. The aim of this study is to compare ‘Fagotti’ diagnostic laparoscopy and preoperative ‘Suidan’ criteria in the selection of patients for primary debulking.

Methodology We retrospectively analyzed the records of patients with advanced ovarian cancer that underwent ‘Fagotti’ diagnostic laparoscopy in the 1st Department of Obstetrics – Gynecology Clinic from 2017 – 2022. The primary outcome was the modification of the debulking surgery.

Results 51 patients with advanced ovarian cancer underwent ‘Fagotti’ diagnostic laparoscopy, in order to decide their treatment plan. 15 patients were excluded from the study, because they did not meet the inclusion criteria. According to the preoperative predictive score, 25 patients were assigned for primary debulking (PDS) (Group A) and 13 patients for neoadjuvant chemotherapy (NACT) followed by interval debulking (IDS) (Group B). After ‘Fagotti’ diagnostic laparoscopy, the treatment plan changed in half of the patients (n=18): 11 from Group A (from PDS to NACT+IDS) and 6 from Group B (from NACT+IDS to PDS). From all patients (n=37) that underwent PDS or IDS, no case of suboptimal cytoreduction was documented (29 RD=0 and 7 RD<1). On the other hand, if the treatment plan was based only on the preoperative predictive score, 11 patients would have been offered an unnecessary suboptimal laparotomy and 6 patients would have been offered NACT, when they could have been offered a successful primary debulking.

Conclusion ‘Fagotti’ diagnostic laparoscopy continues to be the method of choice for the proper selection of patients for primary debulking, despite being an invasive technique.

Disclosures No disclosures.