EP252/#515 Prediction of surgical outcomes of interval debulking surgery (IDS) using in advanced ovarian cancer: a novel scoring system using post-neoadjuvant chemotherapy (NAC) computed tomography (CT). (4th December 2022)

• Record Type: Journal Article
• Authors: Lee, Taekyung; Kim, Na Young; Han, Kyung Hwa; Park, Junsik; Lee, Yong Jae; Lee, Jung-Yun; Jung, Dae Chul
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 3
• Page Start: A152
• Page End: A153
• Publication Date: 2022-12-04
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-igcs.343
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: Residual disease after interval debulking surgery (IDS) is the most critical prognostic predictor in advanced ovarian cancer. Predicting complete resection is important to reduce futile surgery and improve survival rate. The aim of this study is to create new radiologic scoring system in preoperative computed tomography (CT) for prediction of optimal cytoreduction. Methods: CT scans of 72 patients who underwent IDS were retrospectively reviewed. Residual disease measuring ≥ 0.5 cm was presented suboptimal cytoreduction. All surgical record and new radiologic scoring model were made according to Sugarbaker's Peritoneal Cancer Index (PCI). This system scored the degree of tumor extent from 0 to 5 points for each region and the larger the number, the more severe it is. Results: The complete cytoreduction rate of the total study population was 59.7% (n =43). The patients with optimal cytoreduction after IDS had significantly longer progressive free survival than other patients (p value = 0.04). CA125 levels after NAC did not affect optimal resectability (the area under the ROC curve(AUC) = 0.584, 95% CI : 0.450, 0.719). Using univariate and multivariate analysis, in prediction model including the greater omentum, ascending colon and right paracolic, AUC was 0.651 (95% CI: 0.539, 0.763). Using random forest, top 3 CT features were selected with a threshold of 0.1; greater omentum, pelvis, lesser sac and lesser omentum. The top 3 features achieved the AUC of 0.729 (95% CI: 0.622, 0.833). Conclusions: Low CT score of disease at top 3 features on preoperative CT scan can be strong predictor for optimal cytoreduction.