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Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with improved survival in recurrent ovarian cancer (ROC) but carries a high risk of postoperative complications. Accurate perioperative risk stratification remains an unmet need. To develop and internally validate a perioperative risk model for postoperative complications in ROC patients using information available by the end of surgery (pre- and intra-operative data), and to compare logistic regression (LR) and artificial neural networks (ANN) as possible predictive models. A retrospective analysis of 71 patients treated with CRS and HIPEC between 2011 and 2022 was performed. Clinical, surgical, and perioperative variables were analysed. Predictors were restricted to variables available at or before the end of the index operation, which prevents information leakage by using only data available at prediction time. LR and ANN models were developed and assessed with cross-validation. Performance reporting followed TRIPOD (Type b) and TRIPOD + AI, with Brier score, and calibration slope/intercept from out‑of‑fold (OOF) predictions. Thresholded metrics (accuracy, precision, recall, F1 score, and the area under the receiver operating characteristic curve, AUC) were summarised at a prespecified probability cut-off. Exploratory univariate odds ratio analyses with Holm-adjusted p-values were used to explore procedure–complication associations. Postoperative complications occurred in 45% of patients. LR identified blood loss ( p  = 0.005) and number of procedures ( p  = 0.042) as significant predictors of complications. The LR model achieved an accuracy of 66.2%, precision of 64.3%, recall of 56.2%, F1 score of 60.0%, and AUC of 0.700. The ANN model achieved an accuracy of 97.2%, precision of 94.3%, recall of 100%, F1 score of 97.1%, and AUC of 0.967. Hysterectomy with adnexa (OR = 11.67, p  = 0.035) and metastasectomy (OR = 7.42, p  = 0.042) were significantly associated with higher postoperative complication rates. ANN demonstrated superior predictive performance compared to LR in identifying postoperative complications after CRS and HIPEC, as indicated by ROC analysis. Combining traditional statistical modelling with modern machine learning may enhance ROC for perioperative risk stratification after CRS with HIPEC. A well-calibrated, interpretable LR model together with a highly discriminative ANN could enable more tailored allocation of intensive care resources and earlier identification of high-risk patients, potentially improving the safety of this demanding but beneficial treatment. However, external multicentre validation is required before clinical implementation.

In the era of neoadjuvant chemotherapy in advanced gastric cancer (GC), the role of staging laparoscopy (SL) will become more established. However, despite guidelines recommendations, SL for optimal preoperative staging remains underutilized. Diagnostic value of near-infrared (NIR) / indocyanine green (ICG) guided sentinel node (SN) mapping in GC confirmed its technical feasibility, however no data exist regarding its potential role in pathological nodal staging. To the best of our knowledge, current study is the first to evaluate the role of ICG in nodal staging of advanced GC patients undergoing SL. This single-arm prospective observational multicenter study was approved by the Bioethical Committee of Medical University of Lublin (Ethic Code: KE-0254/331/2018). The protocol is registered at clinicaltrial.gov (NCT05720598), and the study results will be reported according to the Strengthening of Reporting of Observational Studies in Epidemiology (STROBE) statement. The primary endpoint of this study is the identification rate of ICG-guided SN in advanced GC patients. The secondary endpoints include pathological and molecular assessment of retrieved SNs and other pretreatment clinical variables potentially associated with SL: pattern of perigastric ICG distribution according to patients' pathological and clinical characteristics, neoadjuvant chemotherapy compliance, 30-day morbidity, and mortality. POLA study is the first to investigate the clinical value of ICG-enhanced sentinel node biopsy during staging laparoscopy in advanced GC patients in a Western cohort. Identifying pN status before multimodal treatment will improve GC staging process.

Background: Recurrent ovarian cancer (ROC) significantly challenges gynecological oncology due to its poor outcomes. This study assesses the impact of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) on ROC survival rates. Materials and Methods: Conducted at the Medical University of Lublin from April 2011 to November 2022, this retrospective observational study involved 71 patients with histologically confirmed ROC who underwent CRS and subsequent HIPEC. Results: The median overall survival (OS) was 41.1 months, with 3-year and 5-year survival rates post-treatment of 0.50 and 0.33, respectively. Patients undergoing radical surgery for primary ovarian cancer had a median OS of 61.9 months. The key survival-related factors included the Peritoneal Carcinomatosis Index (PCI) score, AGO score, platinum sensitivity, and ECOG status. Conclusions: The key factors enhancing ROC patients’ survival include radical surgery, optimal performance status, platinum sensitivity, a positive AGO score, and a lower PCI. This study highlights the predictive value of the platinum resistance and AGO score in patient outcomes, underlining their role in treatment planning. Further prospective research is needed to confirm these results and improve patient selection for this treatment approach.

In the era of neoadjuvant chemotherapy in advanced gastric cancer (GC), the role of staging laparoscopy (SL) will become more established. However, despite guidelines recommendations, SL for optimal preoperative staging remains underutilized. Diagnostic value of near-infrared (NIR) / indocyanine green (ICG) guided sentinel node (SN) mapping in GC confirmed its technical feasibility, however no data exist regarding its potential role in pathological nodal staging. To the best of our knowledge, current study is the first to evaluate the role of ICG in nodal staging of advanced GC patients undergoing SL. This single-arm prospective observational multicenter study was approved by the Bioethical Committee of Medical University of Lublin (Ethic Code: KE-0254/331/2018). The protocol is registered at clinicaltrial.gov (NCT05720598), and the study results will be reported according to the Strengthening of Reporting of Observational Studies in Epidemiology (STROBE) statement. The primary endpoint of this study is the identification rate of ICG-guided SN in advanced GC patients. The secondary endpoints include pathological and molecular assessment of retrieved SNs and other pretreatment clinical variables potentially associated with SL: pattern of perigastric ICG distribution according to patients' pathological and clinical characteristics, neoadjuvant chemotherapy compliance, 30-day morbidity, and mortality. POLA study is the first to investigate the clinical value of ICG-enhanced sentinel node biopsy during staging laparoscopy in advanced GC patients in a Western cohort. Identifying pN status before multimodal treatment will improve GC staging process.