Ovarian Cancer Fagotti Laparoscopic Score — free guideline decision tool
Score seven diagnostic-laparoscopy findings (each 0/2) to predict optimal cytoreduction in advanced ovarian cancer; PIV ≥ 8 favours neoadjuvant chemotherapy. Instant, browser-side.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Peritoneal carcinomatosis (extensive/miliary, unresectable) | No (0) |
|---|---|
| Diaphragmatic carcinomatosis (extensive infiltration/confluent nodules) | No (0) |
| Mesenteric retraction (root infiltration/retraction) | No (0) |
| Omental cake (spread to the greater curvature of the stomach) | No (0) |
| Bowel infiltration (resection required / serosal miliary) | No (0) |
| Stomach infiltration (gastric wall involvement) | No (0) |
| Liver surface metastasis (surface lesion > 2 cm) | No (0) |
→PIV0 pts
- Predictive index value (PIV)：0 pts (max 14) → < 8: optimal cytoreduction is relatively likely achievable
- Decision direction：Favour primary debulking surgery (PDS)
- Notes：Fagotti laparoscopic score: 7 findings each 0/2 (peritoneal/diaphragmatic carcinomatosis, mesenteric retraction, omental cake, bowel/stomach infiltration, liver surface metastasis); optimal cytoreduction defined as residual < 1 cm; diagnostic laparoscopy reduces the futile-laparotomy rate. Must be combined with performance status, imaging (Suidan/CT) and surgeon experience
| Peritoneal carcinomatosis (extensive/miliary, unresectable) | Yes (2) |
|---|---|
| Diaphragmatic carcinomatosis (extensive infiltration/confluent nodules) | Yes (2) |
| Mesenteric retraction (root infiltration/retraction) | Yes (2) |
| Omental cake (spread to the greater curvature of the stomach) | Yes (2) |
| Bowel infiltration (resection required / serosal miliary) | Yes (2) |
| Stomach infiltration (gastric wall involvement) | Yes (2) |
| Liver surface metastasis (surface lesion > 2 cm) | Yes (2) |
→PIV14 pts
- Predictive index value (PIV)：14 pts (max 14) → ≥ 8: low likelihood of optimal cytoreduction (residual < 1 cm) (specificity/PPV ≈ 100%)
- Decision direction：Favour neoadjuvant chemotherapy (NACT) + interval debulking surgery (IDS); avoid a futile laparotomy
- Notes：Fagotti laparoscopic score: 7 findings each 0/2 (peritoneal/diaphragmatic carcinomatosis, mesenteric retraction, omental cake, bowel/stomach infiltration, liver surface metastasis); optimal cytoreduction defined as residual < 1 cm; diagnostic laparoscopy reduces the futile-laparotomy rate. Must be combined with performance status, imaging (Suidan/CT) and surgeon experience
Common questions
What is Ovarian Cancer Fagotti Laparoscopic Score?
Score seven diagnostic-laparoscopy findings (each 0/2) to predict optimal cytoreduction in advanced ovarian cancer; PIV ≥ 8 favours neoadjuvant chemotherapy. Instant, browser-side.
How is Ovarian Cancer Fagotti Laparoscopic Score calculated? What is the core formula?
Predictive index value (PIV) = sum of 7 findings each 0 or 2 (peritoneal/diaphragmatic carcinomatosis, mesenteric retraction, omental cake, bowel/stomach infiltration, liver surface metastasis), max 14. PIV ≥ 8 → optimal cytoreduction unlikely.
When is Ovarian Cancer Fagotti Laparoscopic Score used?
Laparoscopic resectability assessment to guide primary debulking vs neoadjuvant chemotherapy in advanced ovarian cancer.
What are the key clinical points for Ovarian Cancer Fagotti Laparoscopic Score?
Optimal cytoreduction here is defined as residual disease < 1 cm. A PIV ≥ 8 has a very high specificity/PPV for failing optimal cytoreduction and favours neoadjuvant chemotherapy + interval debulking. Diagnostic laparoscopy reduces the rate of futile (open-and-close) laparotomy. Complementary to the Suidan score (CT/clinical) and overall fitness and imaging assessment.
What are the limits and cautions when using Ovarian Cancer Fagotti Laparoscopic Score?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Ovarian Cancer Fagotti Laparoscopic Score calculated in practice? Can you show a worked example?
Inputs: Peritoneal carcinomatosis (extensive/miliary, unresectable) No (0), Diaphragmatic carcinomatosis (extensive infiltration/confluent nodules) No (0), Mesenteric retraction (root infiltration/retraction) No (0), Omental cake (spread to the greater curvature of the stomach) No (0), Bowel infiltration (resection required / serosal miliary) No (0), Stomach infiltration (gastric wall involvement) No (0), Liver surface metastasis (surface lesion > 2 cm) No (0) → Result: PIV 0 pts（Predictive index value (PIV): 0 pts (max 14) → < 8: optimal cytoreduction is relatively likely achievable, Decision direction: Favour primary debulking surgery (PDS), Notes: Fagotti laparoscopic score: 7 findings each 0/2 (peritoneal/diaphragmatic carcinomatosis, mesenteric retraction, omental cake, bowel/stomach infiltration, liver surface metastasis); optimal cytoreduction defined as residual < 1 cm; diagnostic laparoscopy reduces the futile-laparotomy rate. Must be combined with performance status, imaging (Suidan/CT) and surgeon experience） Inputs: Peritoneal carcinomatosis (extensive/miliary, unresectable) Yes (2), Diaphragmatic carcinomatosis (extensive infiltration/confluent nodules) Yes (2), Mesenteric retraction (root infiltration/retraction) Yes (2), Omental cake (spread to the greater curvature of the stomach) Yes (2), Bowel infiltration (resection required / serosal miliary) Yes (2), Stomach infiltration (gastric wall involvement) Yes (2), Liver surface metastasis (surface lesion > 2 cm) Yes (2) → Result: PIV 14 pts（Predictive index value (PIV): 14 pts (max 14) → ≥ 8: low likelihood of optimal cytoreduction (residual < 1 cm) (specificity/PPV ≈ 100%), Decision direction: Favour neoadjuvant chemotherapy (NACT) + interval debulking surgery (IDS); avoid a futile laparotomy, Notes: Fagotti laparoscopic score: 7 findings each 0/2 (peritoneal/diaphragmatic carcinomatosis, mesenteric retraction, omental cake, bowel/stomach infiltration, liver surface metastasis); optimal cytoreduction defined as residual < 1 cm; diagnostic laparoscopy reduces the futile-laparotomy rate. Must be combined with performance status, imaging (Suidan/CT) and surgeon experience）
Run Ovarian Cancer Fagotti Laparoscopic Score now
Score seven diagnostic-laparoscopy findings (each 0/2) to predict optimal cytoreduction in advanced ovarian cancer; PIV ≥ 8 favours neoadjuvant chemotherapy. Instant, browser-side.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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