Parameters:
(1) cytoreductive surgery
(2) extent of peritoneal carcinomatosis (using the Peritoneal Cancer Indiex, PCI)
(3) lymph node metastases
(4) adjuvant chemotherapy
|
Parameter
|
Findings
|
Points
|
|
cytoreductive surgery
|
none or partial
|
0
|
|
|
complete
|
1
|
|
extent of peritoneal carcinomatosis
|
not limited
|
0
|
|
|
limited (PCI <= 6)
|
1
|
|
lymph node metastases
|
present
|
0
|
|
|
absent
|
1
|
|
adjuvant chemotherapy
|
not given
|
0
|
|
|
given
|
1
|
where:
• Extent of peritoneal carcinomatosis showed 3 survival curves: best if PCI <= 6, intermediate if PCI 7 to 19 and worst for PCI > 19.
• Cytoreductive surgery showed 3 survival curves: best if complete (no residual tumor), intermediate for a little and worst for a lot.
number of factors associated with a better prognosis =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number of factors: 0
• maximum number of factors: 4
• The prognosis improved as the number of favorable factors increased.
• Tumor grade and liver metastases did not impact prognosis (but would impact lymph node metastases and extent of peritoneal carcinomatosis).
