A Laparoscopy-Based Score To Predict Surgical Outcome in Patients With Advanced Ovarian Carcinoma: A Pilot Study

Abstract

The reliability of laparoscopy in assessing the chance of optimal cytoreduction can be improved by using a simple scoring system.

Role of CT scan-based and clinical evaluation in the preoperative prediction of optimal cytoreduction in advanced ovarian cancer: a prospective trial

“…Therefore, as a practical rule, the calculation of the rate of inappropriate unexploration can be carried out from our models, as the inverse of PPV and therefore will be 0% at the cutoff values of 7 and 4, in Models 2 and 4, respectively. Finally, more sophisticated imaging approaches such as Positron emission tomography/computed tomography (PET/CT) (Risum et al, 2008), as well as laparoscopic approaches (LPS) scores (Fagotti et al, 2006(Fagotti et al, , 2008Brun et al, 2008) have been recently investigated in terms of prediction of surgical outcome in advanced ovarian cancer, whereas the results of PET/CT seem currently too preliminary to draw any definitive conclusion, data from pilot and prospective studies proposed open LPS as a reliable and flexible predictive tool scores (Fagotti et al, 2006(Fagotti et al, , 2008Brun et al, 2008). Although the accuracy of LPS in the assessment of specific sites of disease involvement is expectedly higher compared with CT scan (Fagotti et al, 2006(Fagotti et al, , 2008Brun et al, 2008), the clinical impact of whether triaging or not advanced ovarian cancer patients to laparotomy on the basis of LPS findings urgently requires to be investigated in controlled clinical trials.…”

“…In this context, much attention has been focused on laboratory assay, clinical and radiographic parameters, or, more recently, laparoscopically assessed scores (Fagotti et al, 2006(Fagotti et al, , 2008Brun et al, 2008) able to preoperatively define each patient's chance to undergo optimal cytoreduction. Although the accuracy of preoperative serum Ca125 levels ranges between 50 and 78%, and conflicting data about the predictive ability of Ca125 levels have been reported (Chi et al, 2000(Chi et al, , 2009Cooper et al, 2002;Saygili et al, 2002;Memarzadeh et al, 2003), computed tomography(CT) scan assessed parameters might conceivably offer better predictive performances, as they define not only the extension of disease, but also more important, the involvement of specific intraabdominal sites generally recognised to heavily preclude the feasibility of optimal debulking, such as portal triad disease, agglutinated bowel/mesentery, bulky diaphragmatic disease, or suprarenal aortic lymph nodes (Eisenkop and Spirtos, 2001).…”

Оптимизация Современных Подходов В Лечении Гинекологического Рака Основных Локализаций

“…В тоже вре-мя на сегодняшний день не существует объективных кри-териев дооперационной оценки возможности выполнения оптимальной или полной циторедукции. В связи с этим ведется поиск шкал интраоперационной оценки воз-можности выполнения полной циторедукции, наиболее востребованной из которых на данный момент является Total Predictive Index Value (PIV), которая была предложе-на в 2006 г. Было показано, что при PIV ≥ 8 вероятность резекции R0 практически равна 0, соответственно, реко-мендовано проведение НАХТ [24]. Кроме того нет четких рекомендаций о применении лапароскопии в диагностике и лечении этой категории больных.…”

Minimally Invasive Surgical Procedures for Patients with Advanced and Recurrent Ovarian Cancer

“…The explanation to this, could be the presence of radiological artifacts due to the effects of chemotherapy, such as adherences or fibrosis secondary to tumor shrinkage, which would probably alter the diagnostic performances of conventional images. The laparoscopic predictive score of surgical outcome www.intechopen.com has been shown to be reliable in selected group of patients (41)(42). The laparoscopic parameters meeting the inclusion criteria have been mesenteral retraction, bowel and stomach infiltration, and superficial liver metastases.…”