Philipp Harter1, Bianca Beutel2, Piero F Alesina3, Dietmar Lorenz4, Andre Boergers5, Florian Heitz2, Rita Hils6, Christian Kurzeder7, Alexander Traut2, Andreas du Bois2. 1. Dept. of Gynecology & Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany; Dept. of Gynecology & Gynecologic Oncology, HSK, Dr. Horst Schmidt Klinik, Wiesbaden, Germany. Electronic address: p.harter@gmx.de. 2. Dept. of Gynecology & Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany; Dept. of Gynecology & Gynecologic Oncology, HSK, Dr. Horst Schmidt Klinik, Wiesbaden, Germany. 3. Dept. of General & Visceral Surgery, Kliniken Essen-Mitte, Essen, Germany. 4. Dept. of General & Visceral Surgery, HSK, Dr. Horst Schmidt Klinik, Wiesbaden, Germany. 5. Dept. of Anesthesiology and Intensive Care, Kliniken Essen-Mitte, Essen, Germany. 6. Dept. of Gynecology & Gynecologic Oncology, HSK, Dr. Horst Schmidt Klinik, Wiesbaden, Germany. 7. Dept. of Gynecology & Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany.
Abstract
OBJECTIVES: The Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) score was developed as selection criteria and validated as predictor of a high probability for complete resection in recurrent ovarian cancer. It is not defined whether the predictive value is independent from underlying tumor biology or is solely based on a selection of good prognostic risks. METHODS: We performed an exploratory analysis of all consecutive patients with cytoreductive surgery in recurrent ovarian cancer in a tertiary referral center 1999-2013, before and after introduction of the AGO score. RESULTS: 217 consecutive patients were included of whom 112 patients were AGO score positive and 105 patients were score negative. Corresponding complete resection rates were 89.3% and 66.7%, respectively, and confirm the score's predictive value. However, a positive AGO score was also associated with better outcome after adjustment for surgical outcome. Patients with complete resection and a positive AGO score showed a median overall survival of 63.9 months (95% CI 48.1-79.6) compared to 48.4 months (95% CI 30.3-66.5) after complete resection and negative score (log-rank p=0.10). However, in multivariate analysis the only independent prognostic factor was complete resection (HR 2.450; 95% CI: 1.542-3.891). CONCLUSIONS: The AGO score could identify suitable candidates for secondary cytoreductive surgery but failed to prove an independent prognostic value thus suggesting an effect of successful surgery on its own. However, the latter has to be proven prospectively. In addition, further studies should evaluate the predictive and prognostic impact of a negative score.
OBJECTIVES: The Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) score was developed as selection criteria and validated as predictor of a high probability for complete resection in recurrent ovarian cancer. It is not defined whether the predictive value is independent from underlying tumor biology or is solely based on a selection of good prognostic risks. METHODS: We performed an exploratory analysis of all consecutive patients with cytoreductive surgery in recurrent ovarian cancer in a tertiary referral center 1999-2013, before and after introduction of the AGO score. RESULTS: 217 consecutive patients were included of whom 112 patients were AGO score positive and 105 patients were score negative. Corresponding complete resection rates were 89.3% and 66.7%, respectively, and confirm the score's predictive value. However, a positive AGO score was also associated with better outcome after adjustment for surgical outcome. Patients with complete resection and a positive AGO score showed a median overall survival of 63.9 months (95% CI 48.1-79.6) compared to 48.4 months (95% CI 30.3-66.5) after complete resection and negative score (log-rank p=0.10). However, in multivariate analysis the only independent prognostic factor was complete resection (HR 2.450; 95% CI: 1.542-3.891). CONCLUSIONS: The AGO score could identify suitable candidates for secondary cytoreductive surgery but failed to prove an independent prognostic value thus suggesting an effect of successful surgery on its own. However, the latter has to be proven prospectively. In addition, further studies should evaluate the predictive and prognostic impact of a negative score.
Authors: P Harter; A du Bois; S Mahner; J Pfisterer; O Ortmann; C Marth; D Fink; F Hilpert; U Wagner; J Sehouli Journal: Geburtshilfe Frauenheilkd Date: 2016-02 Impact factor: 2.915
Authors: Angelo Di Giorgio; Pierandrea De Iaco; Michele De Simone; Alfredo Garofalo; Giovanni Scambia; Antonio Daniele Pinna; Giorgio Maria Verdecchia; Luca Ansaloni; Antonio Macrì; Paolo Cappellini; Valerio Ceriani; Giorgio Giorda; Daniele Biacchi; Marco Vaira; Mario Valle; Paolo Sammartino Journal: Ann Surg Oncol Date: 2016-11-28 Impact factor: 5.344
Authors: Stefano Cianci; Gaetano Riemma; Carlo Ronsini; Pasquale De Franciscis; Marco Torella; Antonio Schiattarella; Marco La Verde; Nicola Colacurci Journal: Gland Surg Date: 2020-08