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🎗️ 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.

Ovarian Cancer Fagotti Laparoscopic Score

Peritoneal carcinomatosis (extensive/miliary, unresectable)
Diaphragmatic carcinomatosis (extensive infiltration/confluent nodules)
Mesenteric retraction (root infiltration/retraction)
Omental cake (spread to the greater curvature of the stomach)
Bowel infiltration (resection required / serosal miliary)
Stomach infiltration (gastric wall involvement)
Liver surface metastasis (surface lesion > 2 cm)

When to use

Laparoscopic resectability assessment to guide primary debulking vs neoadjuvant chemotherapy in advanced ovarian cancer.

How it works

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.

Key points

  • 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.

References

Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.

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