A risk model for secondary cytoreductive surgery in recurrent ovarian cancer: An evidence-based proposal for patient selection Journal Article
| Authors: | Tian, W. J.; Chi, D. S.; Sehouli, J.; Tropé, C. G.; Jiang, R.; Ayhan, A.; Cormio, G.; Xing, Y.; Breitbach, G. P.; Braicu, E. I.; Rabbitt, C. A.; Oksefjell, H.; Fotopoulou, C.; Meerpohl, H. G.; du Bois, A.; Berek, J. S.; Zang, R. Y.; Harter, P. |
| Article Title: | A risk model for secondary cytoreductive surgery in recurrent ovarian cancer: An evidence-based proposal for patient selection |
| Abstract: | Background: To develop a risk model for predicting complete secondary cytoreductive surgery (SCR) in patients with recurrent ovarian cancer. Methods: Individual data of 1075 patients with recurrent ovarian cancer undergoing SCR from 7 worldwide centers were pooled and analyzed. The risk model was developed based on the factors impacting on SCR surgical outcome. Additional data on 117 patients who were not included in the development of the model were used for external validation and to assess the discrimination of the model. Results: Of the 1075 patients, 434 (40.4%) underwent complete resection. Complete secondary cytoreduction was associated with six variables: FIGO stage (odds ratio [OR] = 1.32, 95% confidence interval [95% CI]: 0.97-1.80), residual disease after primary cytoreduction (OR = 1.69, 95% CI: 1.26-2.27), progression-free interval (OR = 2.27, 95% CI: 1.71-3.01), Eastern Cooperative Oncology Group (ECOG) performance status (OR = 2.23, 95% CI: 1.45-3.44), CA125 (OR = 1.85, 95% CI: 1.41-2.44), and ascites at recurrence (OR = 2.79, 95% CI: 1.88-4.13). These variables were entered into the risk model and assigned scores ranging from 0 to 11.9. Patients with total scores of 0-4.7 were categorized as the low-risk group, in which the proportion of complete cytoreduction was 53.4% compared with 20.1% in the high-risk group (OR = 4.55, 95% CI: 3.43-6.04). In external validation, the sensitivity and specificity was 83.3% and 57.6%, respectively. Area under the curve of the receiver-operating characteristics for predicting complete SCR was 0.68 (95% CI: 0.60-0.79). Conclusions: This model and scoring system may well predict the outcome of SCR and could potentially be useful in future clinical trials to determine which patients with recurrent ovarian cancer should have SCR as part of their management. © 2011 Society of Surgical Oncology. |
| Keywords: | adolescent; adult; controlled study; aged; major clinical study; cancer recurrence; area under the curve; ascites; patient selection; validation process; cancer staging; outcome assessment; sensitivity and specificity; cytoreductive surgery; progression free survival; ovary cancer; evidence based practice; prediction; risk; confidence interval; scoring system; high risk population; ca 125 antigen; model; receiver operating characteristic; residual volume |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 19 |
| Issue: | 2 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2012-02-01 |
| Start Page: | 597 |
| End Page: | 604 |
| Language: | English |
| DOI: | 10.1245/s10434-011-1873-2 |
| PROVIDER: | scopus |
| PUBMED: | 21732142 |
| PMCID: | PMC4498288 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 1 March 2012" - "CODEN: ASONF" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work