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. 2018 Feb 23;16(1):37.
doi: 10.1186/s12957-018-1339-0.

Prediction of suboptimal cytoreductive surgery in patients with advanced ovarian cancer based on preoperative and intraoperative determination of the peritoneal carcinomatosis index

Antoni Llueca  1   2   3 , Anna Serra  4 , Isabel Rivadulla  5   4 , Luis Gomez  5   4 , Javier Escrig  5   4   6 ; MUAPOS working group (Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery)
Affiliations

Prediction of suboptimal cytoreductive surgery in patients with advanced ovarian cancer based on preoperative and intraoperative determination of the peritoneal carcinomatosis index

Antoni Llueca et al. World J Surg Oncol. .

Abstract

Background: The peritoneal carcinomatosis index (PCI) can be used to quantify the tumor burden in patients with advanced ovarian cancer. The aim of the present study was to establish a predictive model for suboptimal cytoreductive surgery (SCS) (residual tumor of > 1 cm) using preoperative and intraoperative determination of the PCI.

Methods: In total, 110 consecutive patients treated for advanced ovarian cancer during a 4-year period in our institution were assessed. Eighty of these patients were eligible for primary debulking surgery and thus included in the present study. All data were prospectively collected and retrospectively evaluated. We determined the PCI both preoperatively and intraoperatively and assessed postoperative complications.

Results: A PCI of > 20 was the best cut-off with which to predict a risk of SCS among all three diagnostic techniques assessed in this study (computed tomography, laparoscopy, and laparotomy). Intraoperative PCI determination was associated with the lowest risk of false negatives for SCS when detecting a PCI of < 20. The combination of preoperative computed tomography and laparoscopy, when both techniques predicted SCS, was associated with the lowest risk of false positives for SCS when detecting a PCI of > 20.

Conclusion: The combination of computed tomography and laparoscopy to obtain the PCI can help to determine which patients with advanced ovarian cancer are suitable for primary debulking surgery and which should undergo neoadjuvant chemotherapy.

Keywords: Advanced ovarian cancer; Cytoreductive surgery; Peritoneal carcinomatosis index.

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Conflict of interest statement

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the local ethics and research committee and followed the Declaration of Helsinki guidelines. Written informed consent was required for collecting data.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
CUSUM graph relationship between visceral resections and postoperative complications
Fig. 2
Fig. 2
MUAPOS guide to manage AOC. MUAPOS Multidisciplinary Unit for Abdominal Pelvic Oncology Surgery, AOC advanced epithelial ovarian cancer, PDS primary debulking surgery, IDS interval debulking surgery, CHT chemotherapy, NACT neoadjuvant chemotherapy, RLCU radiologic-laparoscopic criteria for unresectability
See this image and copyright information in PMC

References

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