Prognostic role of the peritoneal cancer index in ovarian cancer patients who undergo cytoreductive surgery: a meta-analysis

Yang, Shu-Li; Si, Li-Hui; Lin, Rui-Xin; Gu, Shi-Yu; Li, Jia-Hui; Cui, Jun-Ze; Yan, Chu-Han; Farah, Abdulkarim Mohamed; Jia, Yan

doi:10.1016/j.currproblcancer.2023.101014

Cited by 2 publications

(4 citation statements)

References 53 publications

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“…Our study, in tandem with a meta-analysis ( 12 ), has firmly established a link between the PCI and poor prognosis in OC patients. Yang et al.…”

Section: Discussionsupporting

confidence: 67%

“…Yang et al. ( 12 ) detailed survival rates across various PCI thresholds, showing significantly lower five-year survival for those exceeding the threshold. To bolster the robustness of our findings, we included recent and contentious prospective clinical studies, applying rigorous inclusion and exclusion criteria.…”

Section: Discussionmentioning

confidence: 99%

“…The study revealed that higher PCI scores are associated with worse 5-year OS (p < 0.001) and 5-year disease-free survival (DFS) rates (p < 0.001). Additionally, a recent meta-analysis showcased that higher PCI scores correlate with lower survival rates, indicating a significant negative correlation between PCI and the survival rate of patients with advanced OC ( 12 ). However, it is important to note that there are also studies presenting different and controversial findings.…”

Section: Introductionmentioning

confidence: 99%

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Does a high peritoneal cancer index lead to a worse prognosis of patients with advanced ovarian cancer?: a systematic review and meta-analysis based on the latest evidence

Wang,

Liu,

Liu

et al. 2024

Front. Oncol.

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BackgroundThe newest clinical evidence that the relationship between the peritoneal cancer index (PCI) and the postoperative prognosis of advanced ovarian cancer patients remains controversial, and there are no large-sample and multicenter studies to clarify this matter. Therefore, in this paper, we used meta-analysis to systematically assess the postoperative prognostic value of PCI in subjects with advanced ovarian cancer to provide individualized treatment plans and thus improve the prognosis of patients.MethodsLiterature on the correlation between PCI and the postoperative prognosis in subjects with advanced OC undergoing cytoreductive surgery (CRS) was searched in the Cochrane Library, Pubmed, Embase, and Web of Science from the database inception to April 20, 2023. The search was updated on February 28, 2024. We only included late-stage (FIGO stage: III-IV) patients who did not undergo neoadjuvant chemotherapy (NACT) or hyperthermic intraperitoneal chemotherapy (HIPEC). Afterwards, literature screening and data extraction were conducted using Endnote20 software. The literature quality was assessed using the Newcastle-Ottawa Scale (NOS). Lastly, statistical analysis was performed with STATA 15.0 software.ResultsFive studies with 774 patients were included. The result indicated that patients with high PCI had a worse prognosis than those with low PCI. The combined hazard ratio was 2.79 [95%CI: (2.04, 3.82), p<0.001] for overall survival (OS) in patients with high PCI. Further subgroup analysis by the FIGO staging revealed that in stage III [HR: 2.61, 95%CI: (2.00, 3.40), p<0.001] and stage III-IV patients [HR: 2.69, 95%CI: (1.66, 4.36), p<0.001], a high PCI score was significantly associated with a worse prognosis. The PCI score had a greater impact on the OS of patients with higher stages. The combined hazard ratio was 1.89 [95%CI: (1.51, 2.36), p<0.001] for progression-free survival (PFS) in patients with high PCI.ConclusionPCI may be used as a postoperative prognosis indicator in patients with advanced OC on primary debulking surgery. High PCI indicates a worse prognosis. However, further research is warranted to confirm these findings.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023424010.

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“…Our study, in tandem with a meta-analysis ( 12 ), has firmly established a link between the PCI and poor prognosis in OC patients. Yang et al.…”

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does a high peritoneal cancer index lead to a worse prognosis of patients with advanced ovarian cancer?: a systematic review and meta-analysis based on the latest evidence

Wang,

Liu,

Liu

et al. 2024

Front. Oncol.

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“…Peritoneal cancer index (PCI) quanti es the tumor burden by considering lesion volume and location during surgery [23]. It is a critical reference for determining the feasibility of CRS completeness [24]. However, calculating the PCI score requires invasive diagnostic laparoscopy, and adhesions or tumors may hinder the assessment of all abdominal regions [25,26].…”

Section: Introductionmentioning

confidence: 99%

Value of an 18F-FDG-based peritoneal cancer index in predicting tumor grade, tumor burden, and completeness of cytoreductive surgery in epithelial ovarian cancer

Zhang,

Li,

Tong

et al. 2024

Preprint

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Background The challenge of treating epithelial ovarian cancer (EOC) is significantly heightened by peritoneal metastasis. 18F-FDG PET/CT is employed as a preoperative assessment method for evaluating the extent of peritoneal spread in EOC, while peritoneal cancer index (PCI) serves as a vital tool in assessing peritoneal dissemination during surgery. We sought to investigate the value of a PCI derived from 18F-FDG PET/CT (PET-PCI) in predicting tumor pathological grade, tumor burden, and completeness of cytoreductive surgery (CRS) in patients with EOC. Methods We conducted a retrospective analysis of 64 patients with the International Federation of Gynecology and Obstetrics (FIGO) stages III–IV or recurrent EOC with peritoneal metastasis who underwent 18F-FDG PET/CT before therapy. PET-PCI was calculated by summing the 18F-FDG uptake scores across 13 abdominopelvic regions. Among them, 23 patients underwent CRS within 2 months after 18F-PET/CT. The relationship between PET-PCI, histological type (I or II), and surgical PCI was analyzed, as was the ability of PET-PCI to predict the completeness of CRS. Results Pathological analysis revealed 14 patients with type I and 50 patients with type II tumors. Compared to patients with type I tumors, those with type II tumors exhibited higher PET-PCI values (19.0 ± 11.1 vs. 12.4 ± 11.5 points, p = 0.022). Setting a cutoff of 15 points for PET-PCI to identify type II EOC resulted in a sensitivity of 56.0%, a specificity of 78.6%, and an AUC of 0.701 (p = 0.023). PET-PCI exhibited a positive correlation with surgical PCI (r = 0.885, p < 0.001). PET-PCI was a significant predictor of CRS completeness, with an AUC of 0.967 (p = 0.004). The cutoff value of 16 for PET-PCI facilitated the identification of CRS completeness in EOC patients, providing a sensitivity of 84.2% and a specificity of 100%. Conclusions This study demonstrated that PET-PCI is a valuable parameter in predicting tumor grade and burden in patients with advanced EOC. Moreover, PET-PCI may serve as a tool for predicting CRS completeness.

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Prognostic role of the peritoneal cancer index in ovarian cancer patients who undergo cytoreductive surgery: a meta-analysis

Cited by 2 publications

References 53 publications

Does a high peritoneal cancer index lead to a worse prognosis of patients with advanced ovarian cancer?: a systematic review and meta-analysis based on the latest evidence

Does a high peritoneal cancer index lead to a worse prognosis of patients with advanced ovarian cancer?: a systematic review and meta-analysis based on the latest evidence

Value of an 18F-FDG-based peritoneal cancer index in predicting tumor grade, tumor burden, and completeness of cytoreductive surgery in epithelial ovarian cancer

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