Comparison of peritoneal carcinomatosis scoring methods in predicting resectability and prognosis in advanced ovarian cancer

Objective: The aim of this study was to compare carcinomatosis scores, and to determine their relevance to predict resectability, morbidity, and outcome.

Study design: From 2005-2008, 61 patients underwent surgery for ovarian cancer. We compared International Federation Gynecology and Obstetrics (FIGO), peritoneal cancer index, Eisenkop, Aletti, Fagotti, and Fagotti-modified scores.

Results: There was a strong correlation between the different scores. In predicting resectability, Fagotti-modified and peritoneal cancer index outperformed other scores. We demonstrated a strong association between the occurrence of postoperative complications and Aletti, peritoneal cancer index, and Eisenkop scores (P < .0001). For progression-free survival, we observed significant differences among FIGO, peritoneal cancer index, Eisenkop, Fagotti-modified, and Aletti stages (P < .05). For stage III/IV patients, only Aletti score remains significant to predict resectability. This suggests that complete respectability is more related to the surgical effort than to the extent of the disease.

Conclusion: Alternative ranking systems provide additional information over FIGO for complete resectability, complications, and survival.