Positron emission tomography-laparoscopy based method in the prediction of complete cytoreduction in platinum-sensitive recurrent ovarian cancer.

Abstract

This study was designed to evaluate the positron emission tomography-laparoscopy-based method in the prediction of complete/optimal cytoreduction in platinum sensitive recurrent epithelial ovarian cancer patients. We analysed 223 consecutive recurrent epithelial ovarian cancer patients. Inclusion criteria were absence of extra-abdominal disease and Eastern Cooperative Oncology Group Performance Status ≤2. Complete and optimal secondary cytoreduction are defined as macroscopic absence or less than 1cm of residual tumor at the end of surgery. Laparoscopy was feasible in 210 of 223 patients (94.2%). Laparoscopy stated 127 (60.5%) possible cytoreductions and 83 (39.5%) systemic chemotherapies. In the same population, AGO score evaluation avowed 150 possible cytoreduction (71.5%) and 60 unresectable women (28.5%). Overall, 115 of 210 patients (54.7%) underwent successful secondary cytoreduction: complete and optimal cytoreduction was obtained in 103 (89.5%) and 12 (10.5%) patients, respectively. Laparoscopy obtained a positive predictive value of 91.3%. Laparoscopy recovered to secondary cytoreduction 13 of 60 patients (21.7%) deemed as not resectable according to AGO score. Forty-eight of 150 AGO score positive patients (32%) were judged nonresectable by laparoscopy. This study confirmed that laparoscopy could be effective for the selection of platinum-sensitive recurrent epithelial ovarian cancer patients suitable for complete cytoreduction.