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

Purpose: 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. Methods: 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. Results: 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. Conclusion: 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.