A Predictive Score for Secondary Cytoreductive Surgery in Recurrent Ovarian Cancer (SeC-Score): A Single-Centre, Controlled Study for Preoperative Patient Selection
A Predictive Score for Secondary Cytoreductive Surgery in Recurrent Ovarian Cancer (SeC-Score): A Single-Centre, Controlled Study for Preoperative Patient Selection
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DOI：
10.1245/s10434-015-4534-z
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发表时间：
2015-12-01
影响因子：
3.7
通讯作者：
Plotti, Francesco
中科院分区：
文献类型：
--
作者：
Angioli, Roberto;Capriglione, Stella;Plotti, Francesco
铂敏感性复发性卵巢癌（ROC）患者的标准治疗方法仍不明确。化疗（CT）和二次细胞减灭术（SCS）是两种有效的选择，即使几项研究证明了更大的生存获益，生存率高达62个月，铂敏感患者接受完整的SCS。本研究的目的是开发一种预测模型，命名为SeC-Score（SeC-s），以评估最佳SCS的风险，包括在文献中首次使用的HE 4。所有在放射学成像中受到可疑ROC影响的患者，被转诊到罗马Campus Bio-medico的妇科，前瞻性地纳入本研究。在我们的预测模型中考虑的术前变量是：年龄，初次减瘤时的残留肿瘤（RT）（0与> 0 cm），术前CA 125和HE 4，以及复发时的腹水。在剖腹探查术后，患者被提交到二次SCS（A组）或寻址到CT（B组）。共135例ROC患者被考虑用于分析。发现首次手术时的术前CA 125、HE 4、腹水和RT具有统计学显著性，并纳入多变量逻辑回归模型，以确定非最佳SCS的风险。在整个患者队列中，SeC-s报告的灵敏度和特异性分别为82%和83%（PPV = 0.79，NPV = 0.81）。我们的数据支持使用SeC-s对适合最佳SCS的术前患者进行分类，即使需要外部验证。
The standard treatments of patients with platinum-sensitive recurrent ovarian cancer (ROC) remains poorly defined. Chemotherapy (CT) and secondary cytoreductive surgery (SCS) represent both valid options, even if several studies demonstrated a greater survival benefit, with survival rates up to 62 months, for platinum-sensitive patients undergoing complete SCS. The purpose of the present study was to develop a predictive model, named SeC-Score (SeC-s), to assess the risk of optimal SCS, including, for the first time in literature, HE4.All patients affected by suspicious ROC at radiologic imaging, referred to the Department of Gynecology of Campus Bio-medico of Rome, were prospectively included in the study. The preoperative variables considered in our predictive model were: age, residual tumour (RT) at primary cytoreduction (0 vs. > 0 cm), preoperative CA125 and HE4, and ascites at recurrence. After exploratory laparotomy, patients were submitted to secondary SCS (Group A) or addressed to CT (Group B).A total of 135 patients with ROC were considered for the analysis. Preoperative CA125, HE4, ascites, and RT at first surgery were found statistically significant and included into a multivariate logistic regression model to determine the risk to not optimal SCS. In the overall cohort of patients, SeC-s reported sensitivity and specificity of 82 and 83 %, respectively (PPV = 0.79, NPV = 0.81).Our data support the use of SeC-s to preoperative triage patients suitable of optimal SCS, even if external validation is needed.