Validation of a peritoneal surface disease severity score in stage IIIC-IV ovarian cancer treated with cytoreduction and hyperthermic intraperitoneal chemotherapy

Antonio, Cascales-Campos Pedro; Jesús, Gómez-Ruiz Álvaro; J, Gil; Gilman, Elena; Alida, González; Machado-Linde, Francisco; Guillermo, Carbonell-López del Castillo; P, Parrilla Paricio

doi:10.1016/j.suronc.2018.11.005

Cited by 6 publications

(5 citation statements)

References 29 publications

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“…There is also a conundrum regarding how to describe total tumor burden in a quantified manner. To solve this, we used PCI score and PSDSS to represent the level of tumor burden, as these scoring systems are objective, implementable, and extensively used in malignancies including gastric cancer and colorectal cancer ( 15 – 18 ). In this study, we collected variables that fully covered demographic characteristics (age), pathological diagnosis (FIGO stage, histology, histologic differentiation, ascites cytology, and lymph node invasion), imaging results (Suidan score, largest tumor size by image), surgical factors (operative time, blood loss, volume of ascites, SCS), the tumor burden (PCI score, PSDSS), results of relevant blood tests (levels of HE4, CA125, CA199, hemoglobin, platelets, WBC, RBC, ALT, AST, TP, ALB, SCr, PT, APTT, TBIL, etc.…”

Section: Discussionmentioning

confidence: 99%

“…We used PCI score and PSDSS to represent the level of tumor burden observed during surgery, as both of these scoring systems are objective, implementable, and frequently used in other malignancies ( 15 – 18 ). PCI score was calculated by assessing the extent of intra-peritoneal disease at diagnosis through quantitatively combining the cancer implant size with the tumor distribution throughout 13 abdominopelvic regions, producing a maximum score of 393.…”

Section: Methodsmentioning

confidence: 99%

“…PSDSS was calculated by integrating clinical symptoms, the extent of carcinomatosis, and primary tumor pathology as reported by Antonio et al. ( 15 ). We also consulted the settings of the AGO score by utilizing three vital factors to assess the gross disease of patients (complete cytoreduction at initial surgery, no ascites, and good performance status at recurrence).…”

Section: Methodsmentioning

confidence: 99%

“…Nomograms are statistical models that condense diverse prognostic variables into user-friendly pictorial representations to estimate the probability of a clinical event, e.g., recurrence or death, for an individual patient ( 11 – 13 ). As we aimed to devise an applicable and reliable model, we considered the use of scoring systems including the Arbeitsgemeinschaft Gynäkologische Onkologie score (AGO), peritoneal cancer index (PCI), and peritoneal surface disease severity score (PSDSS), which are all widely used in other cancers, to evaluate the impact of tumor burden without losing reproducibility ( 14 , 15 ). By integrating prognostic factors including pathological features, surgical factors, and the scoring systems mentioned above, we created a novel prognostic model for OS and PFS in postsurgical EOC patients.…”

Section: Introductionmentioning

confidence: 99%

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Development and External Validation of a Novel Model for Predicting Postsurgical Recurrence and Overall Survival After Cytoreductive R0 Resection of Epithelial Ovarian Cancer

Deng

Wei

et al. 2022

Front. Oncol.

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PurposeTreatment of epithelial ovarian cancer is evolving towards personalization and precision, which require patient-specific estimates of overall survival (OS) and progression-free survival (PFS).Patients and MethodsMedical records of 1173 patients who underwent debulking surgery in our center were comprehensively reviewed and randomly allocated into a derivation cohort of 879 patients and an internal validation cohort of 294 patients. Five hundred and seventy-seven patients from the other three cancer centers served as the external validation cohort. A novel nomogram model for PFS and OS was constructed based on independent predictors identified by multivariable Cox regression analysis. The predictive accuracy and discriminative ability of the model were measured using Harrell’s concordance index (C-index) and calibration curve.ResultsThe C-index values were 0.82 (95% CI: 0.76–0.88) and 0.84 (95% CI: 0.78–0.90) for the PFS and OS models, respectively, substantially higher than those obtained with the FIGO staging system and most nomograms reported for use in epithelial ovarian cancer. The nomogram score could clearly classify the patients into subgroups with different risks of recurrence or postoperative mortality. The online versions of our nomograms are available at https://eocnomogram.shinyapps.io/eocpfs/ and https://eocnomogram.shinyapps.io/eocos/.ConclusionA externally validated nomogram predicting OS and PFS in patients after R0 reduction surgery was established using a propensity score matching model. This nomogram may be useful in estimating individual recurrence risk and guiding personalized surveillance programs for patients after surgery, and it could potentially aid clinical decision-making or stratification for clinical trials.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development and External Validation of a Novel Model for Predicting Postsurgical Recurrence and Overall Survival After Cytoreductive R0 Resection of Epithelial Ovarian Cancer

Deng

Wei

et al. 2022

Front. Oncol.

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“…The surgical peritoneal cancer index (sPCI) and Fagotti score are validated prognostic scores [ 9 10 ]. However, surgical management is invasive and requires additional procedures in patients who are unsuitable for primary debulking surgery.…”

Section: Introductionmentioning

confidence: 99%

Association between High Diffusion-Weighted Imaging-Derived Functional Tumor Burden of Peritoneal Carcinomatosis and Overall Survival in Patients with Advanced Ovarian Carcinoma

Perucho

Chiu

et al. 2022

Korean J Radiol

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Objective To investigate the association between functional tumor burden of peritoneal carcinomatosis (PC) derived from diffusion-weighted imaging (DWI) and overall survival in patients with advanced ovarian carcinoma (OC). Materials and Methods This prospective study was approved by the local research ethics committee, and informed consent was obtained. Fifty patients (mean age ± standard deviation, 57 ± 12 years) with stage III–IV OC scheduled for primary or interval debulking surgery (IDS) were recruited between June 2016 and December 2021. DWI (b values: 0, 400, and 800 s/mm 2 ) was acquired with a 16-channel phased-array torso coil. The functional PC burden on DWI was derived based on K-means clustering to discard fat, air, and normal tissue. A score similar to the surgical peritoneal cancer index was assigned to each abdominopelvic region, with additional scores assigned to the involvement of critical sites, denoted as the functional peritoneal cancer index (fPCI). The apparent diffusion coefficient (ADC) of the largest lesion was calculated. Patients were dichotomized by immediate surgical outcome into high- and low-risk groups (with and without residual disease, respectively) with subsequent survival analysis using the Kaplan-Meier curve and log-rank test. Multivariable Cox proportional hazards regression was used to evaluate the association between DWI-derived results and overall survival. Results Fifteen (30.0%) patients underwent primary debulking surgery, and 35 (70.0%) patients received neoadjuvant chemotherapy followed by IDS. Complete tumor debulking was achieved in 32 patients. Patients with residual disease after debulking surgery had reduced overall survival ( p = 0.043). The fPCI/ADC was negatively associated with overall survival when accounted for clinicopathological information with a hazard ratio of 1.254 for high fPCI/ADC (95% confidence interval, 1.007–1.560; p = 0.043). Conclusion A high DWI-derived functional tumor burden was associated with decreased overall survival in patients with advanced OC.

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Functional tumour burden of peritoneal carcinomatosis derived from DWI could predict incomplete tumour debulking in advanced ovarian carcinoma

Lee

Perucho

et al. 2020

Eur Radiol

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Validation of a peritoneal surface disease severity score in stage IIIC-IV ovarian cancer treated with cytoreduction and hyperthermic intraperitoneal chemotherapy

Cited by 6 publications

References 29 publications

Development and External Validation of a Novel Model for Predicting Postsurgical Recurrence and Overall Survival After Cytoreductive R0 Resection of Epithelial Ovarian Cancer

Development and External Validation of a Novel Model for Predicting Postsurgical Recurrence and Overall Survival After Cytoreductive R0 Resection of Epithelial Ovarian Cancer

Association between High Diffusion-Weighted Imaging-Derived Functional Tumor Burden of Peritoneal Carcinomatosis and Overall Survival in Patients with Advanced Ovarian Carcinoma

Functional tumour burden of peritoneal carcinomatosis derived from DWI could predict incomplete tumour debulking in advanced ovarian carcinoma

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