OBJECTIVE: To present the surgical outcomes of advanced epithelial ovarian cancer (AEOC) since the implementation of a personalized approach and to validate multiple predictive models for R0 resection. METHODS: Personalized strategies included: 1) Non-invasive model: preoperative clinico-radiological assessment according to Suidan criteria with a predictive score for all individuals. Patients with a score 0–2 were recommended for primary debulking surgery (PDS, group A), or otherwise were counseled on the choices of PDS, neoadjuvant chemotherapy (NAC, group B) or staging laparoscopy (S-LPS). 2) Minimally invasive model: S-LPS with a predictive index value (PIV) according to Fagotti. Individuals with a PIV < 8 underwent PDS (group C) or otherwise received NAC (group D). Intraoperative assessment (with Eisenkop, peritoneal cancer index [PCI], and Aletti scores) and surgical results were prospectively collected. RESULTS: Between September 2015 and August 2017, 161 pathologically confirmed epithelial ovarian cancer patients were included. A total of 52 (32.3%) patients had a predictive score of 0–2, and 109 (67.7%) patients had a score ≥ 3. Among these individuals, 41 (25.5%) patients received S-LPS. Finally, 110 (68.3%) patients underwent PDS (A+C), and 51 (31.7%) patients received NAC (B+D). The R0 resection rates in PDS and NAC patients were 56.4% and 60.8%, respectively. The area under the curve (AUC) of Suidan criteria was 0.548 for group (A+C). The AUC of Fagotti score was 0.702 for group C. The AUC of Eisenkop, PCI, and Aletti scores were 0.808, 0.797, and 0.524, respectively. CONCLUSION: The Suidan criteria were not effective in these AEOC patients. S-LPS was helpful in decision-making for PDS and should be endorsed in the future.
Area Under Curve ; Cohort Studies* ; Drug Therapy ; Humans ; Laparoscopy ; Ovarian Neoplasms* ; Prospective Studies* ; Research Design ; Triage*

an those received RH (29% vs. 9%, P=0.042). Conclusion NSRH is safe and feasible surgical management for cervical cancer patients, which would improved the physiology of pelvic autonomic nerve postoperatively.

chronic cervicitis(0%),(P=0.000).The positive rates of EPMMPRIN overexpression in metastatic lymph nodes was 54.5%(12/22),no difference was found from corresponding primary tumor(72.7%,P=0.210).But EMMPRIN overexpression in primary tumor was related to lymph node metastasis(P=0.026),no relationship was found between EMMPRIN expression and other clinical-pathological parameters.Univariate analyses revealed that EMMPRIN expression did not correlate to tumor-specific survival.In contrast,lymph vascular space invasion,deep stromal invasion and lymph node metastasis were significantlyassociated with poor prognosis.In multivariate analysis,lymph-node metastasis was the independent prognostic factor for tumor-specific survival(P=0.006;HR=0.038;95% confidence interval,0.0190.763).Conclusion:EMMPRIN overexpression may play an important role in progression of human cervical cancer,and in the development of cervical cancer from CIN.