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F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) predictive score for complete resection in primary cytoreductive surgery

Publicated to:INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER. 32 (11): 1427-1432 - 2022-09-22 32(11), DOI: 10.1136/ijgc-2022-003883

Authors: Boria, Felix; Chiva, Luis; Carbonell, Maria; Gutierrez, Monica; Sancho, Lidia; Alcazar, Andres; Coronado, Monica; Hernandez Gutierrez, Alicia; Zapardiel, Ignacio;

Affiliations

Clin Univ Navarra, Dept Ginecol & Obstet, Madrid, Spain - Author
Clin Univ Navarra, Madrid, Spain - Author
Clin Univ Navarra, Nucl Med, Madrid, Spain - Author
Clin Univ Navarra, Obstet & Gynecol, Madrid 28027, Spain - Author
Clin Univ Navarra, Radiol Dept, Madrid, Spain - Author
Hosp Univ La Paz, Gynecol Oncol, Madrid, Spain - Author
La Paz Univ Hosp, Gynecol Oncol, Madrid, Spain - Author
La Paz Univ Hosp, Nucl Med, Madrid, Spain - Author
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Abstract

Objective To assess the value of preoperative F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) scan, combined with clinical variables, in predicting complete cytoreduction in selected patients with advanced ovarian cancer. Methods We carried out a multicenter, observational, retrospective study evaluating patients who underwent primary cytoreductive surgery for advanced ovarian cancer in two Spanish centers between January 2017 and January 2022. Inclusion criteria were histological confirmation of invasive epithelial ovarian carcinoma; preoperative International Federation of Gynecology and Obstetrics (FIGO) stage III or IV; upfront cytoreductive surgery; and F-18-FDG PET/CT performed 1 month prior to surgery. A modified F-18-FDG PET/CT peritoneal cancer index score was calculated for all patients. Clinical variables and preoperative F-18-FDG PET/CT findings were analyzed and a multivariate model was constructed. A predictive score based on the odds ratio of the variables was calculated to determine patient selection. Results A total of 45 patients underwent primary cytoreductive surgery. Complete resection was achieved in 36 (80%) patients. On multivariate analysis, two clinical variables (age >= 58 years and American Society of Anesthesiology score >= 3) and two preoperative F-18-FDG PET/CT scan findings (presence of extra-abdominal lymph node involvement and modified peritoneal cancer index value of 6 or more) were associated with gross residual disease. For this multivariate model predictive of non-complete cytoreduction, the area under the curve was 0.881. A predictive value of >= 5 was the most predictive cut-off for gross residual disease. Complete resection rate was 91.7% in patients with a score of <= 4 and 33.3% in patients with a score of >= 5 points on the predictive score. Conclusions In selected patients, a predictive score value >= 5 may be consider as a cut-off point for triaging patients to diagnostic laparoscopy before the primary surgery or neoadjuvant chemotherapy.

Keywords

ovarian cancerpreoperative careAbilityEpithelial ovarian-cancerFdg-pet/ctGross residual diseaseImpactIncomplete cytoreductionMetastasesOvarian cancerPreoperative carePreoperative serum ca-125Primary debulkingScanSurgical oncology

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 13/85, thus managing to position itself as a Q1 (Primer Cuartil), in the category Obstetrics & Gynecology.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 2.17, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-27, the following number of citations:

  • WoS: 1
  • Scopus: 4

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-27:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 5.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 5 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 5.3.
  • The number of mentions on the social network X (formerly Twitter): 9 (Altmetric).

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (ZAPARDIEL GUTIERREZ, IGNACIO).