planning of intervention and care of ovarian cancer surgery is of
outmost importance and involves a wide range of personnel at the
departments involved. The aim of this study is to evaluate the
introduction of an ovarian surgery classification (COVA) system for
facilitating multidisciplinary team (MDT) decisions.
MATERIALS AND METHODS:
hundred eighteen women diagnosed with ovarian cancers (n = 351) or
borderline tumors (n = 66) were selected for primary debulking surgery
from January 2008 to July 2013. At an MDT meeting, women were allocated
into 3 groups named "pre-COVA" 1 to 3 classifying the expected extent of
the primary surgery and need for postoperative care. On the basis of
the operative procedures performed, women were allocated into 1 of the 3
corresponding COVA 1 to 3 groups. The outcome measure was the
predictive value of the pre-COVA score compared with the actual COVA
MDT meeting allocated 213 women (51%) to pre-COVA 1, 136 (33%) to
pre-COVA 2, and 52 (12%) to pre-COVA 3. At the end of surgery, 168 (40%)
were classified as COVA 1, 158 (38%) were classified as COVA 2, and 28
(7%) were classified as COVA 3. Traced individually, 212 (51%) patients
were correctly preclassified at the MDT meeting and distributed into 110
(52%) COVA 1, 71 (52%) COVA 2, and 17 (32%) COVA 3. Analyzing the
subgroup of patients with cancer, 164 (47%) were correctly
preclassified. Regarding the International Federation of Gynecology and
Obstetrics (FIGO) stages, the pre-COVA classification predicted the
actual COVA group in 79 (49%) FIGO stages I to IIIB and in 85 (45%) FIGO
stages IIIC to IV.
COVA classification system is a simple and useful tool in the MDT
setting where specialists make treatment decisions based on advanced
technology. The use of pre-COVA classification facilitates
well-organized patient care-relevant procedures to be undertaken.
Pre-COVA accurately predicts the final COVA in 51% classified women.