| Guangcai Niu,Xiangdong Ma. Peritoneal cancer index is a prognostic indicator of survival in advanced gastric cancer with peritoneal carcinomatosis. Oncol Transl Med, 2020, 6: 116-120. |
| Peritoneal cancer index is a prognostic indicator of survival in advanced gastric cancer with peritoneal carcinomatosis |
| Received:September 04, 2019 Revised:June 17, 2020 |
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| KeyWord:peritoneal cancer index (PCI); advanced gastric cancer (AGC); peritoneal carcinomatosis (PC); survival; complication |
| Author Name | Affiliation | Postcode | | Guangcai Niu | Department of Oncological Surgery, Xuzhou Central Hospital | 221009 | | Xiangdong Ma | Department of Oncological Surgery, Xuzhou Central Hospital | 221009 |
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| Abstract: |
| Objective The peritoneal cancer index (PCI) has been used for the detailed evaluation of the peritoneal
spread in tumors of a gynecologic origin and has been found to be a prognostic indicator of survival. The
aim of this study was to identify the significance of the PCI in advanced gastric cancer (AGC) with peritoneal
carcinomatosis (PC).
Methods From 2010 to 2018, a retrospective analysis was carried out of 60 AGC patients with PC,
including 21 patients with a PCI ≤ 13 and 39 with a PCI > 13. All patients were treated with both surgery
and intraoperative peritoneal hyperthermic chemotherapy (IPHC). The performance status (Karnofsky
performance status), age, sex, Borromann’s classification, differentiation, depth of invasion, lymph node
metastasis, PCI, extent of gastrectomy, extent of lymph node dissection, and residual tumor volume were
retrospectively evaluated and correlated to survival.
Results The overall 5-year survival rate was 43% and mean survival was (54.47 ± 4.53) months. The
favorable clinical prognostic indicators of survival were Borromann’s classification, differentiation, depth
of invasion, PCI, and residual tumor volume on univariate analyses (P < 0.05). The Cox proportional
regression hazard model showed that only the volume of residual tumor and PCI were associated with
postoperative survival. The median survival time was 69.76 months for patients with a PCI ≤ 13 and 39.96
months for patients with a PCI > 13. There was a significant difference in survival rate between the two
group (P = 0.004). Postoperative major morbidity and mortality rates were 23.81% and 4.76% in the PCI ≤
13 group and 43.59% and 5.12% in the PCI > 13 group, respectively.
Conclusion The peritoneal spread in advanced gastric cancer with peritoneal carcinomatosis can
be assessed in detail using the PCI. It is also a significant prognostic factor of survival and is useful in
identifying subgroups. |
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