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122 Preoperative imaging assessment of Peritoneal Cancer Index (PCI): concordance with surgical findings in advanced ovarian cancer. A prospective study
  1. S Greggi1,
  2. O Catalano2,
  3. SV Setola2,
  4. G Casella1,
  5. G Laurelli1,
  6. F Scala1,
  7. V Simeon3,
  8. C Granata2,
  9. A Petrillo2 and
  10. C Scaffa1
  1. 1Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, Department of Gynecologic Oncology, Naples, Italy
  2. 2Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, Department of Radiology, Naples, Italy
  3. 3Università degli Studi della Campania “Luigi Vanvitelli”, Department of Medical Statistics, Naples, Italy


Introduction/Background*The extent of peritoneal spread in advanced ovarian cancer (AOC) heavily impacts on the chance of a complete surgical cytoreduction. The decision-making process on the feasibility of cytoreductive surgery should include a dedicated imaging evaluation. The aim of this study was to prospectively compare a radiologic Peritoneal Cancer Index (rPCI) with the surgical PCI (sPCI).

Methodology 128 consecutive AOC patients planned for cytoreductive surgery underwent preoperative contrast-enhanced Computed Tomography (CT) scan to calculate the rPCI, then the sPCI was determined intraoperatively. CT scans were performed by two dedicated radiologists, and re-evaluated by a third. The rPCI correlation with sPCI was calculated by Lin’s Concordance Correlation Coefficient (CCC), and represented by Bland-Altman agreement plot and Passing-Bablok regression line.

Result(s)*Primary debulking surgery (PDS), and interval debulking surgery (IDS) were performed in 88 and 40 patients, respectively (complete cytoreduction in 56.8% PDS and 67.5% IDS). Overall, mean±SD rPCI was 16.2±6.4 (95%CI:15.1-17.3) and sPCI 14.7±6.9 (95%CI:13.5-15.9), showing a moderate correlation between preoperative CT scan and surgical findings (figures 1-2, CCC=0.64). The best concordance was reported for PDS vs. IDS (CCC=0.64 vs. 0.60) and in middle-high abdominal vs. low quadrants (CCC=0.57 vs. 0.40), while rPCI overestimated ileo-jejunal spread (CCC=0.21).

Conclusion*CT is moderately accurate in predicting the sPCI in AOC patients. The rPCI scoring seems to be helpful and should be part of the decision-making process on surgical cytoreduction.

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