Validation of a peritoneal surface disease severity score in stage IIIC-IV ovarian cancer treated with cytoreduction and hyperthermic intraperitoneal chemotherapy.

BACKGROUND: The aim of the present study is to evaluate and validate the PSDSS score as a prognostic tool in patients with stage IIIC-IV epithelial ovarian cancer (EOC) who are treated with a first cytoreduction with peritonectomy procedures and HIPEC, and to discuss the usefulness and applicability of this approach in decision making in clinical practice. PATIENTS AND METHODS: We analyzed a consecutive series of patients with stage IIIC-IV epithelial ovarian cancer treated by cytoreductive surgery and HIPEC between January 2012 and December 2016. RESULTS: A total of 115 consecutive patients diagnosed of stage IIIC-IV EOC were included. After the multivariate analyses, the impossibility of performing a complete cytoreduction (CC-score = 1, HR: 4.56, p = 0.012), the PSDSSov (III-IV, HR: 3.59, p = 0.024), a high (>20) PCI (HR: 3.16, p = 0.032), and the histological type of the tumor (G3, HR: 2.28, 95% CI: 1.14-8.14, p = 0.033) were factors that were independently related with lower DFS. Other variables included in PSDSSov such as pathological lymphadenopathy and the clinical symptoms were not independently related to lower DFS in our series. CONCLUSIONS: PSDSSov is a useful tool in the prognostic stratification of patients with advanced ovarian cancer with peritoneal dissemination (IIIB/IIIC).