Evaluation of the peritoneal cancer index (PCI) for prediction of outcome in primary debulking surgery of ovarian cancer patients

Background and aim Complete resection of tumor at primary debulking surgery is a strong prognostic factor in advanced stage ovarian cancer. Probability of complete cytoreductive surgery (CRS) depends on the extent of peritoneal carcinomatosis, which can be scored with the peritoneal cancer index (PCI). We evaluated the applicability of the PCI for prediction of CRS success.

Methods Monocentric retrospective cohort study at a tertiary care university hospital center with 795 invasive OC cases 2006 until 2020. Estimation and documentation of the PCI at the beginning of debulking surgery was implemented into routine in 2014. Patients stage FIGO III/IV who received primary surgery using maximum effort with intention of macroscopic complete resection and with complete documentation of PCI and CRS were included.

Results We identified 128 patients eligible for analysis. Median PCI in our whole cohort was 19 (range 14-25). In 99 (77.34%) patients CRS was successful (completeness of cytoreduction [CC]0, no residual macroscopic tumor). PCI was higher in patients with incomplete CRS (CC1-3, median PCI 26, range 23-31) compared to patients with complete CRS (CC0, median PCI 17, range 11-22). ROC analysis revealed an AUC of 0.875 (95% CI, 0.812-0.937) for the PCI as predictor for incomplete CRS. A PCI of 16 or lower detected cases with incomplete CRS with a sensitivity of 100%. Specificity of a PCI score higher than 16 was 48.5%.

Conclusion Our data confirm the PCI as a useful predictor for success of CRS, which could help to stratify patients for optimal treatment.

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Ich erkläre als korrespondierender Autor, dass meine Koautoren mir mitgeteilt haben, dass sie während der letzten 3 Jahre keine wirtschaftlichen oder persönlichen Verbindungen im oben genannten Sinne hatten. Auch ich selbst hatte keine derartigen Verbindungen in den letzten 3 Jahren.

Publikationsverlauf

Artikel online veröffentlicht:
11. Oktober 2022