Introduction: The peritoneal cancer index (PCI) is one of the most important prognostic factors in patients with peritoneal metastases from colorectal cancer undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). The PCI is determined during laparotomy by 2 experienced surgeons and plays a major role in the decision to proceed with CRS-HIPEC. The primary objective of this study was to determine the accuracy of the surgical PCI (sPCI) by comparing it with the PCI confirmed by the pathologist (pPCI). Methods: All consecutive patients who underwent CRS-HIPEC for colorectal peritoneal metastases between February 2015 and June 2018 were identified. Relevant patient- and tumor-related characteristics were collected. Results: In total, 119 patients were included, 60 males (50.4%). The median age was 64 (IQR 55–71). The median sPCI (sPCI = 11, IQR 6–16) was significantly higher than the median pPCI (pPCI = 8, IQR 3–13, p #x3c; 0.001). The total pPCI was lower than the total sPCI in 80 patients (67.2%). In 21 patients (17.6%), the sPCI was overestimated with ≥5 points. Small lesions are more likely to be negative. In patients that underwent resection of their primary tumor prior to CRS-HIPEC, the difference between the sPCI and pPCI was significantly larger (p #x3c; 0.05). Conclusions: Surgical calculation of the PCI often results in overestimation. Far-reaching consequences are tied to the macroscopic evaluation of the sPCI, but this evaluation seems not very reliable.
Dig Surg

中文翻译：

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结直肠癌腹膜转移患者手术腹膜癌指数的准确性

引言：腹膜癌指数（PCI）是结直肠癌腹膜转移患者接受细胞减灭术和腹腔热灌注化疗（CRS-HIPEC）的最重要的预后因素之一。PCI 由 2 位经验丰富的外科医生在剖腹手术期间确定，并在决定是否继续 CRS-HIPEC 中发挥重要作用。本研究的主要目的是通过将手术 PCI (sPCI) 与病理学家确认的 PCI (pPCI) 进行比较来确定手术 PCI (sPCI) 的准确性。方法：确定了 2015 年 2 月至 2018 年 6 月期间因结直肠腹膜转移接受 CRS-HIPEC 的所有连续患者。收集了相关的患者和肿瘤相关特征。结果：共纳入 119 名患者，其中男性 60 名（50.4%）。中位年龄为 64 岁（IQR 55-71）。sPCI 中位数（sPCI = 11，IQR 6-16）显着高于 pPCI 中位数（pPCI = 8，IQR 3-13，p #x3c；0.001）。80 名患者 (67.2%) 的总 pPCI 低于总 sPCI。在 21 名患者 (17.6%) 中，sPCI 被高估 ≥ 5 分。小的病变更可能是阴性的。在 CRS-HIPEC 之前接受原发肿瘤切除术的患者中，sPCI 和 pPCI 之间的差异显着更大 ( p #x3c; 0.05)。结论： PCI 的手术计算常常导致高估。深远的后果与 sPCI 的宏观评估有关，但这种评估似乎不太可靠。
挖掘外科