Editorial for “Diffusion‐Weighted Magnetic Resonance Imaging and Morphological Characteristics Evaluation for Outcome Prediction of Primary Debulking Surgery for Advanced High‐Grade Serous Ovarian Carcinoma”
Abstract
High-grade serous ovarian carcinoma (HGSOC) is one of the most common types of ovarian cancer and the one with the highest mortality rate. Because its associated symptoms are often indolent and nonspecific, diagnosis is typically made only at an advanced stage (FIGO stage III or IV), leading to poor long-term survival. Primary debulking surgery (PDS) and postoperative chemotherapy is presently the standard treatment. The alternative treatment for patients with bulky stage III–IV disease who are nonsurgical candidates is neoadjuvant chemotherapy (NACT) with interval debulking surgery (IDS) and postoperative chemotherapy. While survival is better after PDS, overall prognosis is affected by the presence of residual disease. Therefore, one of the most important goals of the clinician is to determine whether the patient’s disease is resectable up-front, or whether they would benefit from NACT first. Preoperative contrast-enhanced computed tomography (CT) is frequently employed to assess tumor burden and resectability. Most frequently it has been used along with serum tumor antigen CA-125 as part of Suidan’s model to predict residual disease after PDS. However, this model has demonstrated low reliability, interobserver agreement, and accuracy, resulting in inaccurate identification of those patients who have a high likelihood of relapse. More recently, ascites, i.e the accumulation of fluid in the peritoneal cavity that occurs in HGSOC, have shown promise as a predictor of…
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