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A Predictive Score for Secondary Cytoreductive Surgery in Recurrent Ovarian Cancer (SeC-Score): A Single-Centre, Controlled Study for Preoperative Patient Selection

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The standard treatments of patients with platinum-sensitive recurrent ovarian cancer (ROC) remains poorly defined. Chemotherapy (CT) and secondary cytoreductive surgery (SCS) represent both valid options, even if several studies demonstrated a greater survival benefit, with survival rates up to 62 months, for platinum-sensitive patients undergoing complete SCS. The purpose of the present study was to develop a predictive model, named SeC-Score (SeC-s), to assess the risk of optimal SCS, including, for the first time in literature, HE4.

Methods

All patients affected by suspicious ROC at radiologic imaging, referred to the Department of Gynecology of Campus Bio-medico of Rome, were prospectively included in the study. The preoperative variables considered in our predictive model were: age, residual tumour (RT) at primary cytoreduction (0 vs. >0 cm), preoperative CA125 and HE4, and ascites at recurrence. After exploratory laparotomy, patients were submitted to secondary SCS (Group A) or addressed to CT (Group B).

Results

A total of 135 patients with ROC were considered for the analysis. Preoperative CA125, HE4, ascites, and RT at first surgery were found statistically significant and included into a multivariate logistic regression model to determine the risk to not optimal SCS. In the overall cohort of patients, SeC-s reported sensitivity and specificity of 82 and 83 %, respectively (PPV = 0.79, NPV = 0.81).

Conclusions

Our data support the use of SeC-s to preoperative triage patients suitable of optimal SCS, even if external validation is needed.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University of Rome “Campus Bio-Medico”, Rome, Italy

    Roberto Angioli MD, Stella Capriglione MD, Alessia Aloisi MD, Roberto Ricciardi MD, Giuseppe Scaletta MD, Salvatore Lopez MD, Andrea Miranda MD, Anna Di Pinto MD, Corrado Terranova MD & Francesco Plotti MD

Authors
  1. Roberto Angioli MD
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  2. Stella Capriglione MD
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  3. Alessia Aloisi MD
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  4. Roberto Ricciardi MD
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  5. Giuseppe Scaletta MD
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  6. Salvatore Lopez MD
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  7. Andrea Miranda MD
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  8. Anna Di Pinto MD
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  9. Corrado Terranova MD
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  10. Francesco Plotti MD
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Corresponding author

Correspondence to Giuseppe Scaletta MD.

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Angioli, R., Capriglione, S., Aloisi, A. et al. A Predictive Score for Secondary Cytoreductive Surgery in Recurrent Ovarian Cancer (SeC-Score): A Single-Centre, Controlled Study for Preoperative Patient Selection. Ann Surg Oncol 22, 4217–4223 (2015). https://doi.org/10.1245/s10434-015-4534-z

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  • DOI: https://doi.org/10.1245/s10434-015-4534-z

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