RT Journal Article
SR Electronic
T1 Tumor Load Matters – the Peritoneal Cancer Index in Patients With High-grade Serous Ovarian Cancer
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 4825
OP 4831
DO 10.21873/anticanres.15987
VO 42
IS 10
A1 EVA EGGER
A1 FREYA MERKER
A1 DAMIAN J. RALSER
A1 MATEJA CONDIC
A1 MILKA MARINOVA
A1 MICHAEL MUDERS
A1 MATTHIAS STOPE
A1 ALEXANDER MUSTEA
YR 2022
UL http://ar.iiarjournals.org/content/42/10/4825.abstract
AB Background/Aim: The aim of this study was to analyze the predictive and prognostic value of the peritoneal cancer index (PCI) with regard to complete cytoreduction and clinical outcomes in patients with high-grade serous ovarian cancer. Patients and Methods: In a cohort comprising 188 patients with high-grade serous ovarian cancer, the PCI was retrospectively assessed. Clinical factors and perioperative complications were analyzed according to different PCI groups. Five-year disease-free survival (DFS) and overall survival (OS) were calculated based on the Kaplan-Meier Log rank analysis. Receiver operating characteristic (ROC) analysis was applied to detect associations of PCI and complete cytoreduction. Multivariate survival analysis was performed by Cox proportional hazards model. Results: In our study, the PCI was predictive of complete cytoreduction (ROC analysis; AUC 0.8227). In patients with optimal cytoreduction, higher PCI scores were associated with poorer 5-year OS (p<0.001) and 5-year DFS (p<0.001). Complications (G1-G5) were significantly more frequent in patients with PCI scores >9 (p=0.0023). Five-year OS was reduced in patients with severe complications compared to patients with none or mild complications (30.88% versus 51.01%; p=0.001). There were significant OS (p<0.001) and DFS (p<0.001) differences between patients with none or mild versus severe complications following complete cytoreduction within the PCI subgroups (PCI: 9-11, PCI: 12-18, PCI >18). Conclusion: The PCI score showed high predictability for complete cytoreduction and was associated with clinical outcomes. In presence of severe complications, higher PCI scores were associated with poorer survival. Hence, in patients with high tumor load, the prevention of severe perioperative complications is of utmost importance in all cases where complete cytoreduction is deemed to be feasible.