🎗️ 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.
Clinical takeaway
Optimal cytoreduction here is defined as residual disease < 1 cm.
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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.
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
Frequently asked 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）