Comparative Study of Laparascopy Scoring and Laparatomy Staging in Advance Ovarian Cancer

Comparative study between laparoscopic and laparotomy scoring in patients with advanced ovarian cancer.

This prospective study included 27 patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated with Isfahan University of Medical Sciences (IUMS) during 2020 and 2021. The laparoscopic predictive index value (PIV) score (range: 0-14) was calculated for all patients. In patients with PIV scores <8, primary cytoreductive surgery (PCS) was performed, and patients with scores ≥8 were candidates for neoadjuvant chemotherapy (NACT). In the PCS group, laparotomy scoring and surgical findings for each anatomical area were registered for all patients, and concordance between laparoscopy and laparotomy findings was compared. Residual disease following PCS was documented for all patients.

A total of 27 patients underwent laparoscopic scoring surgery; 25 patients (92/5%) had a PIV score <8, and two patients (7/5%) had a PIV score ≥8. There was 92% agreement between PIV scores at laparoscopy and laparotomy. Agreements in different anatomical regions in laparoscopy and laparotomy were as follows: involvement of the bowel 76%, mesenteric 92%, liver 96%, omental 92%, diaphragm 96%, stomach 100%, peritoneal carcinomatosis 96%. A laparoscopic PIV score of <8 had a PPV of 84% at predicting R0 at PCS.

Laparoscopic scoring is a precise approach in the management of patients with advanced ovarian cancer. Laparoscopic scoring is a screening method of selecting patients for primary surgery or NACT and improved R0 resection at PCS. The present study was designed to assess patients who would gain the maximum benefits from primary surgery.