Prospective validation of a laparoscopic predictive model for optimal cytoreduction in advanced ovarian carcinoma

Am J Obstet Gynecol. 2008 Dec;199(6):642.e1-6. doi: 10.1016/j.ajog.2008.06.052. Epub 2008 Sep 17.


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.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Immunohistochemistry
  • Laparoscopy / methods*
  • Laparotomy / methods
  • Middle Aged
  • Neoplasm Invasiveness / pathology*
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Staging
  • Neoplasm, Residual / pathology*
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / surgery*
  • Predictive Value of Tests
  • Probability
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • Survival Analysis
  • Treatment Outcome