Neoadjuvant chemotherapy and cytoreductive surgery in epithelial ovarian cancer

Table 2 Studies of computed tomography scan with or without clinical features to predict surgical outcome in epithelial ovarian cancer

First author, year	n	OS	CT criteria ± clinical feature	Sensitivity	Specificity	PPV	NPV	Accuracy
Using 2 cm as criteria for OS
Nelson et al[52], 1993	421	69%	1 of 8 disease site	92%	79%	67%	96%	86%
Meyer et al[55], 1995	281	57%	5 disease sites	58%	100%	100%	55%	79%
Byrom et al[57], 2002	51	51%	Full/reduced models (same values)	88%	98%	95%	94%	-
			CT with age and CA 125 (not useful)	88%	92%	85%	94%	-
Qayyum et al[62], 2005	137	15%	Either CT (n = 91) or MRI (n = 46)	76%	99%	94%	96%	95% (CT), 96% (MRI)
Using 1 cm as criteria for OS
Dowdy et al[54], 2004	87	71%	3 disease sites (CA 125 not useful)	44%	95%	79%	81%	-
Fujwara et al[56], 2011	98	86%	4 or 6 disease sites (similar values)	-	-	50%	97% or 99%	91% or 94%
Bristow et al[58], 2000	41	49%	13 disease site (predictive index ≥ 4) (age and CA 125 not useful)	100%	85%	88%	100%	93%
Axtell et al[59], 2007	(3 cohorts)		2 disease sites
	65	78%	Cohort A	79%	75%	-	-	77%
	48	41%	Cohort B	15%	32%	-	-	34%
	71	87%	Cohort C	72%	56%	-	-	64%
Gemer et al[60], 2009	123	73%	Nelson’s criteria	64%	64%	-	-	64%
			Qayyum’s criteria	67%	57%	-	-	60%
			Bristow’s criteria	70%	64%	-	-	66%
			Dowdy’s criteria	79%	60%	-	-	65%
Ferrandina et al[61], 2009	195	44%	9 disease sites ± age, CA 125, PS	AUC 0.78 for CT only and 0.81 when added with PS

¹19% of the patients in the study of Nelson et al[52] and 36% in the study of Meyer et al[55] had stage I-II diseases while all other studies included only advanced stage disease. OS: Optimal surgery; CT: Computed tomography; PPV: Positive predictive value; NPV: Negative predictive value; PS: Performance status; CA: Cancer antigen; MRI: Magnetic resonance imaging; AUC: Area under the curve.