Comparison of Peritoneal Carcinomatosis Scoring Methods in Predicting Resectability and Prognosis in Gynecologic Malignancies
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Title
Comparison of Peritoneal Carcinomatosis Scoring Methods in Predicting Resectability and Prognosis in Gynecologic MalignanciesAuthor (s)
Date
2021-06-09Publisher
MDPIISSN
2077-0383Bibliographic citation
Climent, María T., Anna Serra, Juan Gilabert-Estellés, Juan Gilabert-Aguilar, and Antoni Llueca. 2021. "Comparison of Peritoneal Carcinomatosis Scoring Methods in Predicting Resectability and Prognosis in Gynecologic Malignancies" Journal of Clinical Medicine 10, no. 12: 2553. https://doi.org/10.3390/jcm10122553Type
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Abstract
Objective: Peritoneal carcinomatosis is a disease’s presentation in the advanced stages
of many gynecologic tumours. The distribution and volume of the disease are the main factors
in achieving complete debulking. ... [+]
Objective: Peritoneal carcinomatosis is a disease’s presentation in the advanced stages
of many gynecologic tumours. The distribution and volume of the disease are the main factors
in achieving complete debulking. Diagnostic laparoscopy is a technique to allow evaluation of
the disease. This study’s objective is to compare two laparoscopic scores (Fagotti’s index and
Sugarbaker’s peritoneal cancer index (PCI)) and assess the diagnostic accuracy to select patients
for neoadjuvant treatment and reduce unnecessary laparotomies. Methods: A non-randomised
retrospective cohort study was conducted in patients with peritoneal carcinomatosis (ovarian and
endometrial origin) who underwent laparoscopy and subsequent laparotomy. We evaluated the
scores’ ability to predict incomplete surgery and whether they were related to the patients’ prognosis.
Results: We included 34 patients, of which 23.5% received neoadjuvant chemotherapy. The rate of
complete cytoreductive surgery was 79.4% (n = 27 patients). The highest sensitivity was obtained with
a PCI value greater than 20. It was the best parameter to determine incomplete debulking. Survival
curves were analysed according to the “cut off” established for each score, and statically significant
differences were found using PCI with respect to Fagotti’s Index. However, these differences were
not found with Fagotti’s score. Conclusion: The best diagnostic method to classify patients with
peritoneal cancer is the PCI. It could be adapted to each surgical team because it allows identifying
the “cut off point”, which depends on incomplete surgery rate. [-]
Is part of
J. Clin. Med. 2021, 10(12), 2553; https://doi.org/10.3390/jcm10122553Funder Name
Medtronic University Chair for Training and Surgical Research | Universitat Jaume I | Instituto de Salud Carlos III
Project code
PI17/01945
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