Predictive Factors for Achieving Optimal Cytoreduction in Advanced Epithelial Ovarian Cancer: A Multivariate Analysis

Authors

• Kamil Fram
• Amer M. Sindiani
• Khitam I. Mohammad
• Daoud O. Al Aruri
• Dana W. Altarifi
• Dina Hyari
• Lubna Abu Shanab
• Rand Fram
• Mosa Fram
• Somia Zawahreh
• Batool Yamin
• Farah Fram, Henry Ford HealthFollow
• Joud H. Al-abdallat
• Zaid H. Al-Hawari
• Ghazi al Jaloudi, Henry Ford Health
• Zainab Al-Shanti
• Nada Abushalha
• Fadi Odetallah
• Hala Alnawaiseh
• Ranin Awwad

Recommended Citation

Fram K, Sindiani AM, Mohammad KI, Al Aruri DO, Altarifi DW, Hyari D, Shanab LA, Fram R, Fram M, Zawahreh S, Yamin B, Fram F, Al-abdallat JH, Al-Hawari ZH, Al Jaloudi G, Al-Shanti Z, Abushalha N, Odetallah F, Alnawaiseh H, Awwad R. Predictive Factors for Achieving Optimal Cytoreduction in Advanced Epithelial Ovarian Cancer: A Multivariate Analysis. Jordan Med J. 2026;60(4):553-563.

Document Type

Article

Publication Date

8-3-2026

Publication Title

Jordan Med J

Abstract

Objective: Cytoreductive surgery is the cornerstone in the treatment of advanced epithelial ovarian cancer (EOC), with residual disease being the most important prognostic factor. This study aimed to assess the influence of sociodemographic and clinicopathological variables on the likelihood of achieving optimal cytoreduction in patients undergoing debulking surgeries. Methods: A retrospective cohort study was conducted on 63 patients with advanced EOC (FIGO stages III-IV) treated at Jordan University Hospital and King Abdullah University Hospital between January 2010 and December 2023. Data collected included sociodemographic factors, tumor-related clinical characteristics, and surgical outcomes (i.e. optimal and suboptimal). Statistical analysis was performed using Firth logistic regression to identify significant predictors of residual disease following surgery. Results: Of the 63 patients, 47.6% underwent primary debulking surgery (PDS), and 52.4% underwent interval-debulking surgery (IDS). Suboptimal cytoreduction was significantly associated with postmenopausal status (OR = 4.051, p = 0.0061), colon metastasis (OR = 1.791, p = 0.0376), and liver metastasis (OR = 2.934, p = 0.0185). Primary or interval debulking surgery, comorbidities, preoperative CA125 levels, and the number of neoadjuvant chemotherapy cycles were not significant predictors of surgical outcome. The model provided excellent accuracy, with a sensitivity of 86.36% and a specificity of 87.80%. Conclusion: Postmenopausal status and metastases to the liver and colon are key factors for predicting residual disease after debulking surgeries. This highlights the importance of assessing patient demographics and tumor spread when planning surgical interventions. Further research is needed to enhance predictive models to improve outcomes for patients with advanced EOC.

Volume

60

Issue

4

First Page

553

Last Page

563