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

Background & Objective: Comparative study between laparoscopic and laparotomy scoring in patients with advanced ovarian cancer. Materials & Methods: This prospective study included ۲۷ patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated with Isfahan University of Medical Sciences (IUMS) during ۲۰۲۰ and ۲۰۲۱. The laparoscopic predictive index value (PIV) score (range: ۰-۱۴) was calculated for all patients. In patients with PIV scores <۸, primary cytoreductive surgery (PCS) was performed, and patients with scores ≥۸ 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. Results: A total of ۲۷ patients underwent laparoscopic scoring surgery; ۲۵ patients (۹۲/۵%) had a PIV score <۸, and two patients (۷/۵%) had a PIV score ≥۸. There was ۹۲% agreement between PIV scores at laparoscopy and laparotomy. Agreements in different anatomical regions in laparoscopy and laparotomy were as follows: involvement of the bowel ۷۶%, mesenteric ۹۲%, liver ۹۶%, omental ۹۲%, diaphragm ۹۶%, stomach ۱۰۰%, peritoneal carcinomatosis ۹۶%. A laparoscopic PIV score of <۸ had a PPV of ۸۴% at predicting R۰ at PCS. Conclusion: 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 R۰ resection at PCS. The present study was designed to assess patients who would gain the maximum benefits from primary surgery.

کلیدواژه ها:

Laparoscopy ، Laparotomy ، Ovarian cancer ، Neoadjuvant chemotherapy