Abstract
Background:
Peritoneal cancer index (PCI) has been validated in patients of primary advanced epithelial ovarian carcinoma (PAEOC) undergoing primary cytoreductive surgery (PCS) but not in patients undergoing interval cytoreductive surgery (ICS) after neoadjuvant chemotherapy (NACT).
Materials and Methods:
Patients with PAEOC undergoing NACT followed by ICS were included in the study. Inclusion criteria comprised patients with extrapelvic peritoneal metastases on imaging at presentation and high-grade serous histology. PCI score was calculated for every patient using the operative records. Effect of PCI on overall survival (OS), progression-free survival (PFS), and completeness of cytoreduction was evaluated.
Results:
One hundred thirty-eight patients were included in the study. High PCI (10–39) was associated with significantly higher chances of incomplete cytoreduction. The 3-year PFS for low PCI, high PCI, complete cytoreduction, and incomplete cytoreduction were 77.8%, 17.9%, 66.6%, and 27.5%, respectively. The 3-year OS were 89.6%, 35.9%, 79.3%, and 41.6%, respectively. PCI and stage at surgery were found to be independent predictors of OS on multivariate analysis.
Conclusion:
Post-NACT surgical PCI score can be used as a prognostic marker in cases of PAEOC undergoing ICS. Also, a higher PCI score portends an increased likelihood of incomplete cytoreduction. (J GYNECOL SURG 37:331)
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