Llueca Antoni, Escrig Javier
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.
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.
Eur J Surg Oncol. 2018 Jan;44(1):163-169. doi: 10.1016/j.ejso.2017.11.003. Epub 2017 Nov 23.
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.
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.
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.
Given the importance of effective tumor debulking, PCI may provide important information for surgical planning in patients with AOC.
有效的肿瘤细胞减灭术是晚期卵巢癌（AOC）患者预后良好的主要相关因素。然而，国际妇产科联盟（FIGO）分期未能充分考虑腹膜疾病的范围，使得难以规划合适的手术治疗。相比之下，腹膜癌指数（PCI）可以提供有关腹膜播散的更详细信息。
我们评估了PCI在AOC患者中的预后价值及其与临床病理特征的关联。回顾性分析了80例行初次肿瘤细胞减灭术的AOC患者的数据。根据13个腹盆腔区域病变的大小计算PCI评分，0至39分，并将患者分别分为评分1至10分、11至20分和>20分的三类。评估了包括术后残留肿瘤的存在和术后并发症发生率在内的临床病理特征与PCI评分的关系。
PCI与手术不彻底和术后并发症显著相关，也与术前CA125、腹水、手术时间延长、FIGO分期、主动脉旁淋巴结阳性、住院时间延长和内脏切除数量相关。总生存期和无病生存期也与PCI相关，最佳临界值为15。多因素分析确定年龄、残留肿瘤和PCI为生存的独立预后因素。PCI>10与AOC患者的不良预后呈正相关。
鉴于有效的肿瘤细胞减灭术的重要性，PCI可能为AOC患者的手术规划提供重要信息。
