Clinical Validation Of Prediction Models Of Complete Tumor Resection In Secondary Cytoreductive Surgery For Platinum-Sensitive Recurrent Ovarian Cancer

Objective The purpose of this study was to validate the performance of two prediction models,the AGO score and the iMODEL SCR risk scoring system of complete secondary cytoreductive surgery(SCS)in patients with platinum-sensitive recurrent epithelial ovarian cancer,and improve the selection of surgical patients.Methods A retrospective study was conducted on 106 patients with platinum-sensitive recurrent epithelial ovarian cancer who received SCS treatment in the Cancer Hospital Affiliated to the University of Chinese Academy of Sciences from January 2010 to December 2020,and collected clinicopathological data including the general condition of the patient,the initial treatment,the clinical pathological characteristics after the recurrence,and the related conditions of the second surgery.The validation cohorts for the AGO score and the iMODEL SCR risk scoring system(iMODEL group)contained 106(100%)and 82(77.4%)patients,respectively.Sensitivity,specificity,positive predictive values and negative predicted values of the two predictive models were estimated,and the area under the Receiver Operating Characteristic(ROC)curve(AUC)expressed the predictive performance of each score.At the same time,the safety of surgery was evaluated according to the amount of intraoperative bleeding,the amount of blood transfusion,the length of surgery,the scope of surgery,and postoperative complications.Results 1.A total of 106 patients were included in the retrospective analysis,with an average recurrence age of 53.92±8.63 years and a median PFI of 17.93 months(6.27-64.93).2.The rate of complete surgical resection was 81.1%.Univariate analysis showed that recurrence age,FIGO stage,residual disease after primary surgery,pathological classification,degree of tumor differentiation,PFI,ascites at recurrence,serum CA125 level ascites at recurrence,and Eastern Cooperative Oncology Group(ECOG)performance status were not independent influencing factors of complete SCS.3.The AGO score and the iMODEL SCR risk scoring system showed a high positive predictive value for complete SCS of 81.4%and 83.3%respectively,but the false negative rates were not low,of 80.6%and 71.4%,respectively,and the AUC was 0.51(95%CI:0.37-0.65)and 0.58(95%CI:0.43-0.74),respectively.4.The surgery involved a wide range,with a diaphragm resection rate of 30.2%,a bowel resection rate of 27.4%,and a partial liver resection rate of 14.2%.The average intraoperative bleeding volume was 322.14±277.82 ml,and the average surgical duration was 169.23 ± 93.66 minutes.Conclusion Both the AGO score and the iMODEL SCR risk scoring system showed a high positive predictive value but also relatively high false negative rates for complete SCS.SCS surgery is safe.