Prognostic value of the CT-based Suidan scoring system in advanced epithelial ovarian cancer

This study aimed to evaluate the prognostic utility of the Suidan CT-based scoring system in patients with advanced epithelial ovarian cancer (AEOC) undergoing either primary debulking surgery (PDS) or neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS). The score's correlation with residual disease and survival outcomes was examined.

A total of 286 AEOC patients (PDS: 174; NACT-IDS: 112) treated between 2011 and 2020 were retrospectively analyzed. Patients were stratified by Suidan score based on clinical and radiological criteria. Surgical outcomes, progression-free survival (PFS), and overall survival (OS) were compared between treatment groups across score categories.

In the PDS group, increasing Suidan scores correlated with higher rates of residual disease (RD), with 100% RD observed in patients scoring ≥6. NACT-IDS significantly reduced RD rates in patients with Suidan scores ≥2. Among high-score patients (≥6), NACT-IDS was associated with significantly prolonged PFS compared to PDS (27.2 vs. 16.3 months, P = 0.04), though OS remained comparable across groups.

The Suidan score may be a useful preoperative tool for predicting surgical and progression outcomes in AEOC. Patients with high tumor burden (score ≥6) may benefit more from NACT-IDS, highlighting the importance of CT-based stratification in guiding personalized treatment strategies.