Background and Objectives: This study aimed to assess the impact of clinical prognostic factors
and propose a prognostic score that aids the clinician’s decision in estimating the risk for patients
in clinical practice. Materials and Methods: The study included 195 patients diagnosed with ovarian
adenocarcinoma. The therapeutic strategy involved multidisciplinary decisions: surgery followed by
adjuvant chemotherapy (80%), neoadjuvant chemotherapy followed by surgery (16.4%), and only
chemotherapy in selected cases (3.6%). Results: After a median follow-up of 68 months, in terms
of progression-free survival (PFS) and overall survival (OS), Eastern Cooperative Oncology Group
(ECOG) performance status of 1 and 2 vs. 0 (hazard ratio—HR = 2.71, 95% confidence interval—CI,
1.96–3.73, p < 0.001 for PFS and HR = 3.19, 95%CI, 2.20–4.64, p < 0.001 for OS), menopausal vs.
premenopausal status (HR = 2.02, 95%CI, 1.35–3,0 p < 0.001 and HR = 2.25, 95%CI = 1.41–3.59,
p < 0.001), ascites (HR = 1.95, 95%CI 1.35–2.80, p = 0.03, HR = 2.31, 95%CI = 1.52–3.5, p < 0.007),
residual disease (HR = 5.12, 95%CI 3.43–7.65, p < 0.0001 and HR = 4.07, 95%CI = 2.59–6.39, p < 0.0001),
and thrombocytosis (HR = 2.48 95%CI = 1.72–3.58, p < 0.0001, HR = 3.33, 95%CI = 2.16–5.13, p < 0.0001)
were associated with a poor prognosis. An original prognostic score including these characteristics
was validated using receiver operating characteristic (ROC) curves (area under the curve—AUC =
0.799 for PFS and AUC = 0.726 for OS, p < 0.001). The median PFS for patients with none, one, two,
three, or four (or more) prognostic factors was not reached, 70, 36, 20, and 12 months, respectively. The
corresponding median overall survival (OS) was not reached, 108, 77, 60, and 34 months, respectively.
Conclusions: Several negative prognostic factors were identified: ECOG performance status ≥ 1, the presence of ascites and residual disease after surgery, thrombocytosis, and menopausal status. These
led to the development of an original prognostic score that can be helpful in clinical practice