Prognostic value of peritoneal cancer index in primary advanced ovarian cancer

Llueca, Antoni; Escrig-Sos, Javier; Serra-Rubert, A.; Gómez-Quiles, Luis; Rivadulla, Isabel; Játiva-Porcar, Rosa; Moreno-Clarí, E.; Montañés-Pauls, B.; Villach, Laura Granel; Villegas-Cánovas, C.; Ángel-Yepes, V.; Maiocchi, Karina; Medina-Medina, C.; Delgado-Barriga, Katty; Rodrigo-Aliaga, M.; Ruiz, Nuria; López, Adela; Maazouzi, Yasmine; Piquer, Dominique; Segarra, Blanca; Moral, R. Del

doi:10.1016/j.ejso.2017.11.003

Cited by 68 publications

(50 citation statements)

References 21 publications

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“…We also noted that the combination of all three values predicted the incomplete resection of disease in up to 90% of patients even in experienced centers. Llueca and the multidisciplinary unit of abdominal pelvic oncology surgery working group presented a similar study in 2018 16. They evaluated the prognostic value of peritoneal cancer index and its association with clinicopathologic features in patients with advanced epithelial ovarian cancer.…”

Section: Discussionmentioning

confidence: 99%

Pre-operative serum CA125, peritoneal cancer index and intra-operative mapping score as predictors of surgical results in primary epithelial ovarian cancer

Muallem

Sehouli

Richter

et al. 2019

Int J Gynecol Cancer

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ObjectivePrediction of post-operative residual disease after ovarian cancer cytoreductive surgery remains a topic of interest to gynecologic oncologists. The aim of this study was to explore the correlation between serum CA125, peritoneal cancer index, and intra-operative mapping of ovarian cancer and their predictive value for post-operative outcome.MethodsA total of 70 patients with primary epithelial ovarian cancer, who underwent primary cytoreductive surgery at Charité, Berlin between January 2013 and February 2014 were included. In all patients, pre-operative CA125 values, intra-operative peritoneal cancer index, and intra-operative mapping of ovarian cancer were determined.ResultsUsing a receiver operating characteristic analysis, cut-off values for CA125, peritoneal cancer index, and intra-operative mapping of ovarian cancer score could be defined. Patients with pre-operative serum CA125 >600 U/mL had a three times higher risk for residual tumor after primary cytoreductive surgery (p=0.037). A peritoneal cancer index score >20 indicated a nine times increased risk for residual tumor (p=0.003). More than six affected abdominopelvic fields on the intra-operative mapping of ovarian cancer was associated with a 25 times higher risk of residual tumor after primary cytoreductive surgery (p≤0.05). The combination of all three values predicted residual tumor in up to 90% of patients.ConclusionWe found that pre-operative CA125 >600 U/mL, peritoneal cancer index >20, and intra-operative mapping of ovarian cancer score >6 could be used as predictors of complete tumor resection. The combination of all these three values predicted the incomplete resection of disease in up to 90% of patients even in experienced centers.

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Section: Discussionmentioning

confidence: 99%

Pre-operative serum CA125, peritoneal cancer index and intra-operative mapping score as predictors of surgical results in primary epithelial ovarian cancer

Muallem

Sehouli

Richter

et al. 2019

Int J Gynecol Cancer

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“…In our trial, oral administration of I3C and EGCG as maintenance therapeutic agents in advanced OC has demonstrated dramatic increase in median OS (almost one and a half times) and median PFS (approximately double). HR levels calculated with multivariate Cox regression analysis indicate that long-term maintenance therapy with I3C as well as maintenance therapy with I3C and EGCG are independent favorable prognostic factors statistically significantly associated with increase in OS and PFS after adjustment for some variables, including PCI, having well-known prognostic value in primary advanced OC [ 25 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Peritoneal cancer index (PCI) was determined for all patients in the study at screening using data obtained by thoracoabdominal computed tomography to assess the initial tumor spread [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

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A new promising way of maintenance therapy in advanced ovarian cancer: a comparative clinical study

Киселев

Ashrafyan

Muyzhnek³

et al. 2018

BMC Cancer

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BackgroundThere is an urgent need for more novel and efficacious therapeutic agents and strategies for the treatment of ovarian cancer - one of the most formidable female malignancies. These approaches should be based on comprehensive understanding of the pathobiology of this cancer and focused on decreasing its recurrence and metastasis. The aim of this study was to evaluate the efficacy of five-year maintenance therapy with indole-3-carbinol (I3C) as well as I3C and epigallocatechin-3-gallate (EGCG) conducted before, during, and after combined treatment compared with combined treatment alone in advanced ovarian cancer.MethodsPatients with stage III-IV serous ovarian cancer were assigned to receive combined treatment plus I3C (arm 1), combined treatment plus I3C and EGCG (arm 2), combined treatment plus I3C and EGCG plus long-term platinum-taxane chemotherapy (arm 3), combined treatment alone without neoadjuvant platinum-taxane chemotherapy (control arm 4), and combined treatment alone (control arm 5). Combined treatment included neoadjuvant platinum-taxane chemotherapy, surgery, and adjuvant platinum-taxane chemotherapy. The primary endpoint was overall survival (OS). Secondary endpoints were progression-free survival (PFS) and rate of patients with recurrent ovarian cancer with ascites after combined treatment.ResultsAfter five years of follow-up, maintenance therapy dramatically prolonged PFS and OS compared to control. Median OS was 60.0 months (95% CI: 58.0–60.0 months) in arm 1, 60.0 months (95% CI: 60.0–60.0 months) in arms 2 and 3 while 46.0 months (95% СI: 28.0–60.0 months) in arm 4, and 44.0 months (95% СI: 33.0–58.0 months) in arm 5. Median PFS was 39.5 months (95% СI: 28.0–49.0 months) in arm 1, 42.5 months (95% СI: 38.0–49.0 months) in arm 2, 48.5 months (95% СI: 39.0–53.0 months) in arm 3, 24.5 months (95% СI: 14.0–34.0 months) in arm 4, 22.0 months (95% СI: 15.0–26.0 months) in arm 5. The rate of patients with recurrent ovarian cancer with ascites after combined treatment was significantly less in maintenance therapy arms compared to control.ConclusionsLong-term usage of I3C and EGCG may represent a new promising way of maintenance therapy in advanced ovarian cancer patients, which achieved better treatment outcomes.Trial registrationRetrospectively registered with ANZCTR number: ACTRN12616000394448. Date of registration: 24/03/2016.

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“…Several studies have been performed to investigate the accuracy of preoperative radiological features and parameters of exploratory laparoscopy [4][5][6][7][8][9]. As a result, models based on preoperative radiological assessment or exploratory laparoscopies were applied to filter patients with advanced EOC but the satisfactory PDS would be unavailable.…”

Section: Introductionmentioning

confidence: 99%

Role of Laparotomy-based Parameters in Assessment of Optimal Primary Debulking Surgery and Long-term Outcomes in Patients with Stage IIIC Epithelial Ovarian Cancer

Zhou¹,

Wang²,

Long³

et al. 2020

J. Cancer

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We evaluated the ability of our two laparotomy-based models to predict optimal primary debulking surgery (PDS) and long-term outcomes of stage IIIC epithelial ovarian cancer (EOC). Data of 400 IIIC EOC patients who underwent laparotomy were retrospectively analyzed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated for 10 parameters. The parameters with a specificity ≥75%, PPV ≥50%, and NPV ≥50% were included in the final predictive index value (PIV) model. Peritoneal cancer index (PCI) was calculated summarizing lesion size scores (LSSs) of 13 regions. Receiver operating characteristic (ROC) curve was used to assessed the predictive value of PIV and PCI for optimal PDS. Univariate and multivariate analyses were performed to assess the prognostic value of PIV and PCI. After PDS, 223 (55.8%) patients with RD ≤1 cm had longer progression-free survival (PFS) and overall survival (OS) than patients with RD >1 cm (PFS: 22.4 vs. 15.4 months, respectively; P < 0.001 and OS: 48.6 vs. 35.6 months; P < 0.001). PCI better predicted optimal PDS than PIV (The area under the curve of ROC: PCI 0.79 vs. PIV 0.75). The predictive value of PIV and PCI models was verified using another cohort of 77 patients. And PIV and PCI models were demonstrated to be more powerful than the published laparoscopy-based predictive index (LPS-PI) model. Patients with a PIV ≥14 were more likely to undergo suboptimal PDS with a specificity of 100%. The median PFS and OS of patients with PIV < 3 were significantly longer than patients with PIV > 3 (PFS: 19.5 vs. 16.3 months, P = 0.007; OS: 46.1 vs. 37.0 months, P = 0.009). The median PFS and OS of patients with the PCI < 17.5 were significantly longer than patients with the PCI > 17.5 (PFS: 22.9 vs. 14.5 months, P < 0.001; OS: 54.3 vs. 31.5 months, P < 0.001). PCI could better predict optimal PDS compared with PIV. PCI was an independent prognostic factor for long-term outcome of IIIC EOC patients.

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Prognostic value of peritoneal cancer index in primary advanced ovarian cancer

Cited by 68 publications

References 21 publications

Pre-operative serum CA125, peritoneal cancer index and intra-operative mapping score as predictors of surgical results in primary epithelial ovarian cancer

Pre-operative serum CA125, peritoneal cancer index and intra-operative mapping score as predictors of surgical results in primary epithelial ovarian cancer

A new promising way of maintenance therapy in advanced ovarian cancer: a comparative clinical study

Role of Laparotomy-based Parameters in Assessment of Optimal Primary Debulking Surgery and Long-term Outcomes in Patients with Stage IIIC Epithelial Ovarian Cancer

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