Pacyna Rachel R, Thomas Leah, Oren Nisa C, Kim Josephine S
Pritzker School of Medicine, The University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, USA.
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, 9500 Gilman Dr La Jolla, CA 92093, USA.
Gynecol Oncol Rep. 2025 Jul 16;60:101805. doi: 10.1016/j.gore.2025.101805. eCollection 2025 Aug.
Peritoneal cancer index (PCI) is a numerical score that quantifies tumor extent in colorectal cancers. More recently it has been applied to ovarian cancers. However, the prognostic value of PCI in patients with low grade serous ovarian carcinoma (LGSOC) is not well characterized. We investigated whether pre-operative CT imaging could predict intraoperative disease extent and outcomes in LGSOC patients using PCI. We also investigated the association between PCI scores and cytoreduction outcomes.
Advanced stage LGSOC who had undergone preoperative CT imaging, cytoreductive surgery, and follow-up in the study timeframe were included. PCI was calculated based on the Sugarbaker method (Harmon & Sugarbaker, 2005). A blinded radiologist calculated CT-PCI scores. Surgical PCI was calculated retrospectively from operative reports. The relationship between CT-PCI and surgical PCI was determined using univariate linear regression. Surgical and survival outcomes were assessed.
For 21 patients (median age at cancer diagnosis = 58 years old, interquartile range (IQR) = 54-69), mean CT-PCI was 13 (SD: 8). Mean surgical PCI was 12 (SD: 7). CT-PCI significantly predicted surgical PCI (beta-coefficient = 0.59, p-value = 0.001). CT-PCI overestimated surgical PCI in 71 % of patients. Neither CT-PCI nor surgical PCI were significantly associated with optimal cytoreduction, though a trend was observed toward higher PCI scores in patients who were sub-optimally cytoreduced.
CT-PCI significantly predicts surgical PCI in a small, retrospective cohort of patients with LGSOC. CT-PCI may be useful to estimate surgical PCI and possibly cytoreductive outcome in LGSOC. However, CT-PCI can overestimate surgical PCI and should not be used to preclude LGSOC patients from a cytoreduction attempt.
腹膜癌指数（PCI）是一种量化结直肠癌肿瘤范围的数字评分。最近它已应用于卵巢癌。然而，PCI在低级别浆液性卵巢癌（LGSOC）患者中的预后价值尚未得到充分表征。我们研究了术前CT成像是否可以使用PCI预测LGSOC患者的术中疾病范围和预后。我们还研究了PCI评分与肿瘤细胞减灭术结果之间的关联。
纳入在研究时间段内接受过术前CT成像、肿瘤细胞减灭术和随访的晚期LGSOC患者。PCI根据Sugarbaker方法（Harmon和Sugarbaker，2005年）计算。一名盲法放射科医生计算CT-PCI评分。手术PCI从手术报告中回顾性计算。使用单变量线性回归确定CT-PCI与手术PCI之间的关系。评估手术和生存结果。
对于21例患者（癌症诊断时的中位年龄 = 58岁，四分位间距（IQR） = 54 - 69），平均CT-PCI为13（标准差：8）。平均手术PCI为12（标准差：7）。CT-PCI显著预测手术PCI（β系数 = 0.59，p值 = 0.001）。71%的患者中CT-PCI高估了手术PCI。CT-PCI和手术PCI均与最佳肿瘤细胞减灭术无显著关联，尽管在肿瘤细胞减灭术不理想的患者中观察到PCI评分较高的趋势。
在一个小型回顾性LGSOC患者队列中，CT-PCI显著预测手术PCI。CT-PCI可能有助于估计LGSOC患者的手术PCI以及可能的肿瘤细胞减灭术结果。然而，CT-PCI可能高估手术PCI，不应将其用于排除LGSOC患者进行肿瘤细胞减灭术尝试。
