A Predictive Score for Secondary Cytoreductive Surgery in Recurrent Ovarian Cancer (SeC-Score): A Single-Centre, Controlled Study for Preoperative Patient Selection

Abstract

Our data support the use of SeC-s to preoperative triage patients suitable of optimal SCS, even if external validation is needed.

The addition of lymphadenectomy to secondary cytoreductive surgery in comparison with bulky node resection in patients with recurrent ovarian cancer

“…2 However, growing evidence underlines that secondary cytoreductive surgery (SCS) may have a role in a selected population of patients with ROC. [5][6][7][8] Several studies have investigated the role of SCS in patients with ROC, and demonstrate that patients having complete resection of the recurrent disease experienced improvements in survival rate. [5][6][7][8] Patients with isolated nodal disease could be seen as the ideal candidates for SCS since it is known that complete resection of recurrent disease is associated with improved survival rate.…”

The Diagnostic Accuracy of Human Epididymis Factor 4 for the Prediction of Optimal Debulking in Patients With Ovarian Cancer: A Meta-Analysis of Observational Studies

“…As previously mentioned, 3 studies were excluded from the present meta-analysis. 20,22,26 It is important to mention that in one of those studies, despite the adequate sensitivity (0.77), HE4 had quite a low specificity rate (0.47) in predicting ovarian cancer. 26 On the other hand, in the study of Karlsen et al, HE4 was significantly better than CA-125 (AUC 0.785 vs 0.678) in predicting optimal debulking.…”

“…Data in the field of secondary debulking remain very limited because only 2 studies refer to patients with disease relapse. 22,23 Nevertheless, both of them suggest promising results. The meta-regression analysis revealed that the definition of optimal debulking was an independent factor that significantly affected the results of our analysis.…”

“…20,22,26 Outcomes The sensitivity of HE4 for the prediction of optimal debulking, irrespective of the factors that contributed to heterogeneity, was 0.81 (95% CI 0.74Y0.86) (Fig. 4) and the pooled specificity was 0.80 (95% CI 0.75Y0.84) (Fig.…”

Surgical management of recurrent ovarian cancer

“…An ongoing phase III trial (DESKTOP III) will answer the question of whether there is any OS benefit of SCS in patients with platinum-sensitive ROC with a positive AGO-score. More recently, an Italian study group proposed a new predictive Secondary Cytoreduction Score (SeC-S), with sensitivity and specificity of 82% and 83%, respectively [48]. The SeC-S was calculated from a logistic regression equation to determine the probability of not achieving optimal SCS using the following 4 variables: preoperative CA-125, HE4, ascites, and residual tumor at primary surgery.…”