Antoni Llueca1, Javier Escrig2. 1. Department of Obstetrics and Gynecology, University General Hospital of Castellon, Castellón, Spain; Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellon, Castellón, Spain; Department of Medicine, University Jaume I(UJI), Castellon, Spain. Electronic address: antonillueca@gmail.com. 2. Department of General Surgery, University General Hospital of Castellon, Castellón, Spain; Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellon, Castellón, Spain; Department of Medicine, University Jaume I(UJI), Castellon, Spain.
Abstract
BACKGROUND: Effective tumor debulking is a major factor associated with a favorable prognosis in patients with advanced ovarian cancer (AOC). However, FIGO staging fails to take full account of the extent of the disease in the peritoneum, making it difficult to plan appropriate surgical treatment. In contrast, the peritoneal cancer index (PCI) can provide more detailed information about peritoneal spread. METHOD: We evaluated the prognostic value of PCI and its association with clinicopathological features in patients with AOC. Data for 80 patients with AOC who underwent primary debulking surgery were analyzed retrospectively. PCI scores of 0-39 were calculated based on the sizes of lesions in 13 abdominopelvic regions, and patients were classified into three categories with scores of 1-10, 11-20, and >20, respectively. Clinicopathological features, including the presence of residual tumor after surgery and the incidence of postoperative complications, were assessed in relation to PCI score. RESULTS: PCI was significantly associated with suboptimal surgery and postoperative complications, as well as with preoperative CA125, ascites, prolonged surgery, FIGO stage, positive aortic lymph nodes, prolonged hospitalization, and number of visceral resections. Overall and disease-free survival was also associated with PCI, with an optimal cut-off value of 15. Multivariate analysis identified age, residual tumor, and PCI as independent prognostic factors for survival. A PCI >10 is positively associated with a poor prognosis in patients with AOC. CONCLUSION: Given the importance of effective tumor debulking, PCI may provide important information for surgical planning in patients with AOC.
BACKGROUND: Effective tumor debulking is a major factor associated with a favorable prognosis in patients with advanced ovarian cancer (AOC). However, FIGO staging fails to take full account of the extent of the disease in the peritoneum, making it difficult to plan appropriate surgical treatment. In contrast, the peritoneal cancer index (PCI) can provide more detailed information about peritoneal spread. METHOD: We evaluated the prognostic value of PCI and its association with clinicopathological features in patients with AOC. Data for 80 patients with AOC who underwent primary debulking surgery were analyzed retrospectively. PCI scores of 0-39 were calculated based on the sizes of lesions in 13 abdominopelvic regions, and patients were classified into three categories with scores of 1-10, 11-20, and >20, respectively. Clinicopathological features, including the presence of residual tumor after surgery and the incidence of postoperative complications, were assessed in relation to PCI score. RESULTS: PCI was significantly associated with suboptimal surgery and postoperative complications, as well as with preoperative CA125, ascites, prolonged surgery, FIGO stage, positive aortic lymph nodes, prolonged hospitalization, and number of visceral resections. Overall and disease-free survival was also associated with PCI, with an optimal cut-off value of 15. Multivariate analysis identified age, residual tumor, and PCI as independent prognostic factors for survival. A PCI >10 is positively associated with a poor prognosis in patients with AOC. CONCLUSION: Given the importance of effective tumor debulking, PCI may provide important information for surgical planning in patients with AOC.
Authors: Vsevolod I Kiselev; Levon A Ashrafyan; Ekaterina L Muyzhnek; Evgeniya V Gerfanova; Irina B Antonova; Olga I Aleshikova; Fazlul H Sarkar Journal: BMC Cancer Date: 2018-09-20 Impact factor: 4.430
Authors: Antoni Llueca; Anna Serra; Karina Maiocchi; Katty Delgado; Rosa Jativa; Luis Gomez; Javier Escrig Journal: Int J Womens Health Date: 2019-03-07
Authors: Antoni Llueca; Anna Serra; Maria Teresa Climent; Blanca Segarra; Yasmine Maazouzi; Marta Soriano; Javier Escrig Journal: World J Surg Oncol Date: 2020-11-25 Impact factor: 2.754