Article Text
Abstract
Introduction/Background Extent of tumour load is one of the important factors selecting patients with advanced ovarian cancer for cytoreductive surgery (CRS). Peritoneal cancer index (PCI) gives exact information on tumour distribution and is a prognostic factor of survival, but is still not standard in ovarian cancer surgery.
The aim of this study was to find a PCI cut-off value for complete cytoreductive surgery and second aims to identify reasons for open-close, and to correlate tumour burden with surgical complications.
Methodology One-hundred-sixty-seven women with advanced ovarian cancer planned for CRS were included in the study. Possible predictors of operability were evaluated with receiver operator curves (ROC) and a PCI cut-off was identified. The study population was then divided in groups by cut-off value and differences in peri-or postoperative complications were analysed by one-way ANOVA or Chi-square tests.
Results The median PCI score for all patients was 22 (range 3–37). Complete CRS was achieved in 148 (88.1%) patients. The median PCI for patients with incomplete surgery was 33 (range 25–37) of whom 14 were open-close. Intraoperative PCI score was an excellent predictor of operability with an AUC of 0.945 (95% CI 0.91–0.98) (figure 1). For patients with PCI >33, only 28.6% achieved complete CRS (table 1). In patients with PCI >24 complete CRS was obtained in 67.2% but with an increased rate of complications (p=0.008). Reasons for all open-close were massive carcinomatosis on the small bowel.
Conclusion Peritoneal cancer index (PCI) was an excellent predictor of operability and more complications were found with higher tumour burden. Radiologic methods to evaluate preoperative PCI should be further evaluated and PCI used as a tool to compare study populations in surgical studies.
Disclosure Nothing to disclose.