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Prognostic Significance of Sugarbaker’s Peritoneal Cancer Index for the Operability of Ovarian Carcinoma
  1. Bjoern Lampe, MD, PhD*,
  2. Nadine Kroll, MD*,
  3. Pompiliu Piso, MD, PhD,
  4. Dirk Michael Forner, MD and
  5. Peter Mallmann, MD, PhD§
  1. *Kaiserswerther Diakonie, Florence Nightingale Hospital, Duesseldorf;
  2. Krankenhaus Barmherzige Brüder Regensburg, Regensburg;
  3. Sana Klinikum Remscheid, Remscheid; and
  4. §Universitäts-Frauenklinik Köln, Köln, Germany.
  1. Address correspondence and reprint requests to Bjoern Lampe, MD, PhD, Kaiserswerther Diakonie, Florence Nightingale Hospital, Kreuzbergstraße 79, D-40489 Duesseldorf, Germany. E-mail: lampe{at}


Introduction This study aimed to investigate Sugarbaker’s peritoneal cancer index (PCI) as a prognostic indicator for the resectability of ovarian carcinoma (OC), as depicted in the study using the completeness of cytoreduction score (CCS).

Currently, the intraoperative assessment of operability in OC surgery is primarily a subjective measurement that is dependent on the surgeon.

Methods The retrospective data from 98 patients with OC International Federation of Gynecology and Obstetrics (FIGO) III to IV who had received surgery between January 2010 and December 2011 were analyzed. The PCI and the CCS were determined retrospectively using surgical reports, histological findings, and intraoperative photographic documentation. Receiver operating characteristic curves and ordinal regression were applied to evaluate the predictability of CCS using the PCI.

Results Of 98 patients, 80 (81.6%) were staged FIGO III and 18 (18.4%) FIGO IV. A statistically significant correlation was demonstrated between the PCI and CCS (P < 0.01). A receiver operating characteristic curve with an area under the curve of 0.839 demonstrated the high precision in discrimination with which the PCI could predict the CCS. Using ordinal regression, it was possible to estimate the probabilities of achieving CCS 0, CCS 1, CCS 2, or CCS 3 for a given PCI (pseudo R2 according to Cox and Snell 0.428, Nagelkerke 0.476, and McFadden 0.244).

Conclusions The PCI more precisely defined the heterogeneous group of patients with OC FIGO III. The PCI provided objectivity and reproducibility, and it seems to be a possible prognostic indicator for OC resectability.

  • Ovarian cancer
  • Carcinomatosis
  • Peritoneal cancer index
  • Resectability
  • Ovarian cancer surgery

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  • The authors declare no conflicts of interest.