Predicting Surgical Outcome in Patients With International Federation of Gynecology and Obstetrics Stage III or IV Ovarian Cancer Using Computed Tomography

Abstract

Currently, there are no external validated studies with a good predictive performance for residual disease. Studies of better quality are needed, especially studies that focus on predicting any residual disease after surgery.

Why have ovarian cancer mortality rates declined? Part II. Case-fatality

“…The most common factors precluding complete surgical resection are extensive disease involving the upper abdomen, small bowel mesentery or the portal triad. Some have proposed that the probability that surgery will result in no residual disease can be predicted through a pre-operative assessment, which incorporates various factors such as tumor marker expression and the extent of disease detected through imaging or laparoscopy [29,33,34]. However, the ability of pre-operative criteria to reliably predict surgical outcome remains weak.…”

Development of a preoperative computed tomography score for the management of advanced epithelial ovarian cancer

“…Sub-optimal resection surgery and neoadjuvant chemotherapy were considered a negative outcome whereas complete debulking was classified as a success. All the radiologic features were selected from an accurate review of the literature made by Rutten et al5 A point value was assigned to each parameter according to its association with the outcome in terms of sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy (Table 2). A predictive index value ranging from 0 to 24 points was obtained by adding the scores of each parameter.…”

Classification of Ovarian Cancer Surgery Facilitates Treatment Decisions in a Gynecological Multidisciplinary Team

“…Although several models including laparoscopic assessment have been evolved to predict the outcome of extensive surgery to identify the patients suitable for primary extensive surgery, currently, no externally validated studies have solved the problem. 33,34 Unfortunately, PET/CT in our hands does not optimally predict tumor resection and radical surgery in patients with ovarian cancer, although we use it to guide us for selective resections as, for instance, splenectomy. 35 Fotopoulou et al 36 made an intraoperative mapping on tumor dissemination pattern based on information extracted from the surgical records, from interviewing the surgeons and from the histological findings in 360 women with epithelial ovarian cancer FIGO stages III to IV.…”

“…However, most such studies that evaluate preoperative tools to predict surgical outcome are based on specific tumor sites and parameters found by different imaging techniques or biomarkers. 33,39 In these studies, the end points are not a standardized predictive classification of the operative procedures to achieve complete tumor resection as presented here. Furthermore, the needed patient informed decision making before surgery is based on a conglomerate of these factors and may deviate from the MDT decision because of adverse women accepts as, for instance, refusal to have a stoma.…”