Publication Type : Journal Article
Publisher : Springer Science and Business Media LLC
Source : Indian Journal of Gynecologic Oncology
Url : https://doi.org/10.1007/s40944-024-00895-w
Keywords : Staging laparoscopy Fagotti score CT-PCI
Campus : Kochi
School : School of Medicine
Department : Medical Oncology
Year : 2024
Abstract :
Introduction : In clinically advanced ovarian cancer, staging laparoscopy (S-LPS) can be a useful tool to accurately identify patients who can undergo complete cytoreduction from those who are more suitable for NACT (Neoadjuvant chemotherapy).
Aim : To study the usefulness of S-LPS as a diagnostic tool for triaging advanced ovarian cancer to surgery/NACT and to study the correlation between the laparoscopic predictive index value (PIV) and CT-PCI (CT based peritoneal cancer index).
Methods : Single institution retrospective cohort study conducted in a tertiary care oncology center from Jan 2021–November 2022. All patients who underwent S-LPS to determine primary resectability using the Fagotti score before triaging to CRS (Cytoreductive surgery)/NACT were included (CRS group/ no CRS group). The CT scans were retrospectively reviewed, and scored by an experienced radiologist who was blinded to the operative findings, and the correlation between CT PCI score and Fagotti’s score was studied.
Results : Out of the 225 patients treated for ovarian cancer in our department for ovarian cancer in the study period, 40 patients underwent S-LPS and were included for the study. Out of these, 19 patients were found to be eligible for CRS based on the Fagotti score, all of whom had optimal cytoreduction. 21 were found to be ineligible for CRS, for whom biopsy was taken and these patients were sent for NACT. Ascites > 500 ml was the only factor found to be significantly associated with the no CRS group.
For intra-rater reliability between CT scores and PIV in CRS group, the agreement was− 0.178 (− 0.012, 0.368) indicating very low reliability. In the no CRS group, the agreement was − 0.092 (− 0.24, 0.06) suggesting no reliability.
Conclusion : Laparoscopy is an underutilized but useful tool in clinically advanced cases of carcinoma ovary/primary peritoneal carcinoma to triage patients who have an over/underestimation of disease by CT scan/CA − 125 levels. Correlation between CT PCI and Fagotti’s PIV was not very reliable.
Cite this Research Publication : Saumya Gupta, Priya Bhati, Sunil Patel, Niveditha Kartha, Keechilat Pavithran, Clinical Usefulness of Fagotti’s Predictive Index Value, and Its Correlation with CT Based Peritoneal Cancer Index: Experience from a Tertiary Care Oncology Center in South India, Indian Journal of Gynecologic Oncology, Springer Science and Business Media LLC, 2024, https://doi.org/10.1007/s40944-024-00895-w