Dr. Duska on the Utility of the Fagotti Score in Advanced Ovarian Cancer

Linda R. Duska, MD, professor of obstetrics and gynecology and gynecologic oncologist at the University of Virginia, explains whether the Fagotti score provides an accurate assessment of whether a patient with newly diagnosed, advanced ovarian cancer can achieve a complete resection in surgery.

The Fagotti score can be useful in determining whether a patient with newly diagnosed, advanced ovarian cancer can undergo optimal debulking surgery in the hands of an experienced surgeon, explains Duska. However, it is not the sole way to assess resectability. A small laparotomy could be performed instead, in addition to performing imaging, a CT scan, a PET scan, or an MRI, says Duska.

Ultimately, resectability should be assessed by a trained gynecologic oncologist. Having a gynecologic oncologist involved in the care of women with advanced disease from the onset of treatment is important, says Duska. However, that is not always possible, especially in community practices where general surgeons or gynecologists are more likely to perform the surgery. When that happens, the patient’s likelihood of receiving an appropriate surgery decreases, concludes Duska.