Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Hai Dian District, Beijing, 100142, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Hai Dian District, Beijing, 100142, China.
J Cancer Res Clin Oncol. 2024 Apr 30;150(5):222. doi: 10.1007/s00432-024-05707-4.
The purpose of this research was to investigate the efficacy of the CT-based peritoneal cancer index (PCI) to predict the overall survival of patients with peritoneal metastasis in gastric cancer (GCPM) after two cycles of chemotherapy.
This retrospective study registered 112 individuals with peritoneal metastasis in gastric cancer in our hospital. Abdominal and pelvic enhanced CT before and after chemotherapy was independently analyzed by two radiologists. The PCI of peritoneal metastasis in gastric cancer was evaluated according to the Sugarbaker classification, considering the size and distribution of the lesions using CT. Then we evaluated the prognostic performance of PCI based on CT, clinical characteristics, and imaging findings for survival analysis using multivariate Cox proportional hazard regression.
The PCI change ratio based on CT after treatment (ΔPCI), therapy lines, and change in grade of ascites were independent factors that were associated with overall survival (OS). The area under the curve (AUC) value of ΔPCI for predicting OS with 0.773 was higher than that of RECIST 1.1 with 0.661 (P < 0.05). Patients with ΔPCI less than -15% had significantly longer OS.
CT analysis after chemotherapy could predict OS in patients with GCPM. The CT-PCI change ratio could contribute to the determination of an appropriate strategy for gastric cancer patients with peritoneal metastasis.
本研究旨在探讨 CT 腹膜肿瘤指数（PCI）对胃癌腹膜转移（GCPM）患者化疗 2 周期后总生存的预测效能。
本回顾性研究登记了我院 112 例胃癌腹膜转移患者。由 2 名放射科医生分别对化疗前后的腹部和骨盆增强 CT 进行独立分析。根据 Sugarbaker 分类，考虑 CT 上病变的大小和分布，评估胃癌腹膜转移的 PCI。然后，我们使用多变量 Cox 比例风险回归对 CT、临床特征和影像学发现进行生存分析，评估 PCI 的预后性能。
治疗后 CT 上的 PCI 变化率（ΔPCI）、治疗线数和腹水分级变化是与总生存（OS）相关的独立因素。ΔPCI 预测 OS 的曲线下面积（AUC）值为 0.773，高于 RECIST 1.1 的 0.661（P<0.05）。ΔPCI 小于-15%的患者 OS 明显更长。
化疗后 CT 分析可预测 GCPM 患者的 OS。CT-PCI 变化率有助于确定胃癌腹膜转移患者的适当治疗策略。
