Ovarian cancer remains the leading cause of gynecologic malignancy related morbidity and mortality in the United States. The American Cancer Society predicts that in 2023, there will be 19, 710 new cases with 13,270 expected to die of disease [1]. The majority of these women are diagnosed at advanced stage of disease (AOC) at presentation.

Primary cytoreductive surgery followed by chemotherapy has been the standard of care for women with AOC. The goal of surgical resection is the removal of all visible tumor (optimal) as the amount of residual tumor at the end of surgery represents one of the most important prognostic factors [2,3]. Attempts have been made to identify factors which deem patients unresectable at the time of primary cytoreductive surgery, including imaging criteria, tumor markers, and laparoscopic criteria [[4], [5], [6], [7], [8]]. Neoadjuvant chemotherapy (NACT) followed by interval cytoreductive surgery (IDS) is considered an acceptable alternative in patients with advanced ovarian cancer with high unresectable tumor burden or high perioperative risk [[9], [10], [11]]. With these findings, the frequency of NACT and IDS has increased significantly in the United States [12].

The criteria for minimally invasive surgery (MIS) in ovarian cancer are not only confined to a diagnostic role, but have been used in the surgical management of early stage ovarian cancer and to identify patients not responding to second-line chemotherapy [13,14]. Although operative treatment for gynecologic tumors has historically been performed via laparotomy, thanks to technological progress and an increased number of skilled laparoscopic surgeons, minimally invasive surgery has shown promise in regards to its role in minimally invasive interval debulking surgery after NACT [15].

To date there are a limited number of studies evaluating MIS IDS. Moreover, these studies were dedicated towards a highly defined population within the group of patients who undergo neoadjuvant chemotherapy [[16], [17], [18]]. There is a lack of data, not only for the intervention of MIS IDS, but also in identifying for which patients this procedure would produce an optimal cytoreduction and if there are any preoperative parameters for which this procedure should not be offered. We sought to create a laparoscopic-based model to predict the ability to perform a MIS IDS in AOC patients who have received neoadjuvant chemotherapy.