AN OVERVIEW OF MULTI-VARIATE ANALYSES OF PROGNOSTIC VARIABLES WITH SPECIAL REFERENCE TO THE ROLE OF CYTOREDUCTIVE SURGERY

Background: Cytoreductive surgery is still widely believed to be a cor nerstone in the management of advanced ovarian cancer. In the absence of data from prospective randomized trials, multi-variate analysis can assist in evaluating the role of optimal surgical cytoreduction relat ive to other possible prognostic variables. Materials and methods: Pub lished analyses of prognostic variables have been reviewed and the con sistency and reproducibility of variables have been considered. Result s: When reviewing the most recent literature it is obvious that there is a need to develop a consensus as to the most important patient char acteristics which should be reported. Furthermore, these characteristi cs need to be standardized as do definitions such as toxicity, grading , and response criteria and duration. Subjective variables such as per formance status, histological grading and typing, present a special pr oblem as these lack reproducibility. The overview of multi-variate ana lyses for prognostic variables such as residual tumour size, tumour si ze prior to cytoreductive surgery, cisplatin therapy, grade, stage, hi stology, and performance status demonstrates that the impact of indivi dual prognosticators depends on the indicators included in the analysi s and that the importance of these variables could change as new techn ologies and treatments are introduced. Conclusions: The collection of a single data base including all known variables reported for each pat ient with appropriate attention to the careful evaluation of subjectiv e indicators should be undertaken, with a view to establishing a progn ostic index. This would allow the relative risk for individual patient s to be assessed.