Radiologic and surgical peritoneal cancer index in patients with low grade serous ovarian carcinoma

Background: Peritoneal cancer index (PCI) is a numerical score that quantifies tumor extent in colorectal cancers. More recently it has been applied to ovarian cancers. However, the prognostic value of PCI in patients with low grade serous ovarian carcinoma (LGSOC) is not well characterized. We inve...

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Main Authors: Rachel R. Pacyna, Leah Thomas, Nisa C. Oren, Josephine S. Kim
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Gynecologic Oncology Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352578925001304
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author Rachel R. Pacyna
Leah Thomas
Nisa C. Oren
Josephine S. Kim
author_facet Rachel R. Pacyna
Leah Thomas
Nisa C. Oren
Josephine S. Kim
author_sort Rachel R. Pacyna
collection DOAJ
description Background: Peritoneal cancer index (PCI) is a numerical score that quantifies tumor extent in colorectal cancers. More recently it has been applied to ovarian cancers. However, the prognostic value of PCI in patients with low grade serous ovarian carcinoma (LGSOC) is not well characterized. We investigated whether pre-operative CT imaging could predict intraoperative disease extent and outcomes in LGSOC patients using PCI. We also investigated the association between PCI scores and cytoreduction outcomes. Methods: Advanced stage LGSOC who had undergone preoperative CT imaging, cytoreductive surgery, and follow-up in the study timeframe were included. PCI was calculated based on the Sugarbaker method (Harmon & Sugarbaker, 2005). A blinded radiologist calculated CT-PCI scores. Surgical PCI was calculated retrospectively from operative reports. The relationship between CT-PCI and surgical PCI was determined using univariate linear regression. Surgical and survival outcomes were assessed. Results: For 21 patients (median age at cancer diagnosis = 58 years old, interquartile range (IQR) = 54–69), mean CT-PCI was 13 (SD: 8). Mean surgical PCI was 12 (SD: 7). CT-PCI significantly predicted surgical PCI (beta-coefficient = 0.59, p-value = 0.001). CT-PCI overestimated surgical PCI in 71 % of patients. Neither CT-PCI nor surgical PCI were significantly associated with optimal cytoreduction, though a trend was observed toward higher PCI scores in patients who were sub-optimally cytoreduced. Conclusion: CT-PCI significantly predicts surgical PCI in a small, retrospective cohort of patients with LGSOC. CT-PCI may be useful to estimate surgical PCI and possibly cytoreductive outcome in LGSOC. However, CT-PCI can overestimate surgical PCI and should not be used to preclude LGSOC patients from a cytoreduction attempt.
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spelling doaj-art-2d7572baba9c479aa529d211eecdf9992025-08-21T04:17:11ZengElsevierGynecologic Oncology Reports2352-57892025-08-016010180510.1016/j.gore.2025.101805Radiologic and surgical peritoneal cancer index in patients with low grade serous ovarian carcinomaRachel R. Pacyna0Leah Thomas1Nisa C. Oren2Josephine S. Kim3Pritzker School of Medicine, The University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, USA; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, 9500 Gilman Dr La Jolla, CA 92093, USAPritzker School of Medicine, The University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, USA; Department of Medicine, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USADepartment of Radiology, Silver Cross Hospital, 1900 Silver Cross Blvd, New Lenox, IL 60451, USADepartment of Obstetrics and Gynecology/Section of Gynecologic Oncology, The University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, USA; Corresponding author.Background: Peritoneal cancer index (PCI) is a numerical score that quantifies tumor extent in colorectal cancers. More recently it has been applied to ovarian cancers. However, the prognostic value of PCI in patients with low grade serous ovarian carcinoma (LGSOC) is not well characterized. We investigated whether pre-operative CT imaging could predict intraoperative disease extent and outcomes in LGSOC patients using PCI. We also investigated the association between PCI scores and cytoreduction outcomes. Methods: Advanced stage LGSOC who had undergone preoperative CT imaging, cytoreductive surgery, and follow-up in the study timeframe were included. PCI was calculated based on the Sugarbaker method (Harmon & Sugarbaker, 2005). A blinded radiologist calculated CT-PCI scores. Surgical PCI was calculated retrospectively from operative reports. The relationship between CT-PCI and surgical PCI was determined using univariate linear regression. Surgical and survival outcomes were assessed. Results: For 21 patients (median age at cancer diagnosis = 58 years old, interquartile range (IQR) = 54–69), mean CT-PCI was 13 (SD: 8). Mean surgical PCI was 12 (SD: 7). CT-PCI significantly predicted surgical PCI (beta-coefficient = 0.59, p-value = 0.001). CT-PCI overestimated surgical PCI in 71 % of patients. Neither CT-PCI nor surgical PCI were significantly associated with optimal cytoreduction, though a trend was observed toward higher PCI scores in patients who were sub-optimally cytoreduced. Conclusion: CT-PCI significantly predicts surgical PCI in a small, retrospective cohort of patients with LGSOC. CT-PCI may be useful to estimate surgical PCI and possibly cytoreductive outcome in LGSOC. However, CT-PCI can overestimate surgical PCI and should not be used to preclude LGSOC patients from a cytoreduction attempt.http://www.sciencedirect.com/science/article/pii/S2352578925001304Low grade serous ovarian carcinomaPeritoneal cancer indexCytoreductionImaging
spellingShingle Rachel R. Pacyna
Leah Thomas
Nisa C. Oren
Josephine S. Kim
Radiologic and surgical peritoneal cancer index in patients with low grade serous ovarian carcinoma
Gynecologic Oncology Reports
Low grade serous ovarian carcinoma
Peritoneal cancer index
Cytoreduction
Imaging
title Radiologic and surgical peritoneal cancer index in patients with low grade serous ovarian carcinoma
title_full Radiologic and surgical peritoneal cancer index in patients with low grade serous ovarian carcinoma
title_fullStr Radiologic and surgical peritoneal cancer index in patients with low grade serous ovarian carcinoma
title_full_unstemmed Radiologic and surgical peritoneal cancer index in patients with low grade serous ovarian carcinoma
title_short Radiologic and surgical peritoneal cancer index in patients with low grade serous ovarian carcinoma
title_sort radiologic and surgical peritoneal cancer index in patients with low grade serous ovarian carcinoma
topic Low grade serous ovarian carcinoma
Peritoneal cancer index
Cytoreduction
Imaging
url http://www.sciencedirect.com/science/article/pii/S2352578925001304
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AT josephineskim radiologicandsurgicalperitonealcancerindexinpatientswithlowgradeserousovariancarcinoma