Prospective validation of a laparoscopic predictive model for optimal cytoreduction in advanced ovarian carcinoma - 21/08/11
Reprints: Prof Giovanni Scambia, MD, Department of Obstetrics and Gynecologic, Catholic University, L.go A Gemelli, 8, 00168, Rome, ItalyRésumé |
Objective |
The purpose of this study was to validate the performance of a laparoscopy-based model to predict optimal cytoreduction in advanced ovarian cancer patients.
Study Design |
In a consecutive prospective series of 113 advanced ovarian cancer patients, the presence of omental cake, peritoneal and diaphragmatic extensive carcinosis, mesenteric retraction, bowel and stomach infiltration, spleen and/or liver superficial metastasis were investigated by laparoscopy. By summing the scores relative to all parameters, a laparoscopic assessment for each patient (total predictive index value = PIV) has been calculated. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy have been calculated for each PIV.
Results |
The overall accuracy rate of the laparoscopic procedure ranged between 77.3 and 100%. At a PIV ≥ 8 the probability of optimally resecting the disease at laparotomy is equal to 0, and the rate of unnecessary exploratory laparotomy is 40.5%.
Conclusion |
The proposed laparoscopic model appears a reliable and flexible tool to predict optimal cytoreduction in advanced ovarian cancer.
Le texte complet de cet article est disponible en PDF.Key words : cytoreduction, laparoscopy, ovarian cancer
Plan
| Cite this article as: Fagotti A, Ferrandina G, Fanfani F, et al. Prospective validation of a laparoscopic predictive model for optimal cytoreduction in advanced ovarian carcinoma. Am J Obstet Gynecol 2008;199:642.e1-642.e6. |
Vol 199 - N° 6
P. null - décembre 2008 Retour au numéro
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