Objective:
A numerical score, the Peritoneal Cancer Index (PCI), was developed to reflect the
extent of tumor growth in gastric and colorectal cancers and to tailor treatment.
This study aimed to examine the value of the PCI score in advanced epithelial ovarian
cancer (EOC) regarding completeness of surgical cytoreduction and survival.
Methods:
This was a prospective cohort study. Patients with primary serous EOC at FIGO stages
IIIB or higher were included. Patients with FIGO stage IVB as well as those assigned
to receive neoadjuvant treatment were excluded from the study. The PCI was obtained
and registered intraoperatively.
Results:
In the study period we recruited 96 patients with serous EOC stage IIIB – IVA. A PCI
score cut-off value of 13 was calculated using a receiver operator characteristic
(ROC) curve, above which worse survival is expected (AUC 0.641, 95% CI 0.517 – 0.765,
sensitivity and specificity 80.6%, 45%, respectively, p = 0.05). A multivariate analysis
determined that suboptimal surgical cytoreduction was the only independent predictive
factor for recurrence (OR 7.548, 95% CI 1.473 – 38.675, p = 0.015). A multivariate
analysis determined that only suboptimal surgical cytoreduction (HR 2.33, 95% CI 0.616
– 8.795, p = 0.005), but not PCI score > 13 (HR 1.289, 95% CI 0.329 – 5.046, p = 0.716),
was an independent predictive factor for death.
Conclusions:
We conclude from this study that the PCI score is a reliable tool helping to assess
the extent of disease in advanced serous EOC and may help predicting complete surgical
cytoreduction but cannot qualify as a predictor of survival.
