We evaluated the ability of our newly developed laparotomy-based model to predict optimal primary debulking surgery (PDS) and long-term outcomes of stage IIIC epithelial ovarian cancer (EOC).
Data of 400 IIIC EOC patients who underwent laparotomy were retrospectively analyzed to investigate predictors of optimal PDS. Parameters including infiltration of the bowel, peritoneum, diaphragm, hepatic surface, spleen, and stomach; omental caking; mesenteric retraction; and metastasis of the pelvic and para-aortic lymph nodes increased the difficulty of surgery. The parameters with a specificity ≥75%, positive predictive value ≥50%, and negative predictive value ≥50% were included in the final predictive index value (PIV) model. Each parameter was assigned a score based on the strength of its statistical association, and a total PIV was tabulated for each patient. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive ability of the model. Subgroup analyses were performed in patients with RD > 1 cm and ≤1 cm.
After PDS, 223 (55.8%) patients with RD ≤ 1 cm had longer progression-free survival (PFS) and overall survival (OS) than patients with RD > 1 cm (PFS: 24.3 vs. 15.9 months; P
When PDS left RD of ≤ 1 cm, patients with a PIV of 1 cm, patients who were sensitive to platinum had a better prognosis. Additionally, patients with a lymph node rate of > 32.5% were more likely to progress.
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All authors have declared no conflicts of interest.