title: Mapping the location of peritoneal metastases using the peritoneal cancer index and the correlation with overall survival: a retrospective study.
abstract: OBJECTIVE
  Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising treatment for patients with peritoneal carcinomatosis (PC). Our objective was to identify new prognostic factors within the Peritoneal Cancer Index (PCI) score in PC patients.
  
  
  METHODS
  140 patients (60 ovarian, 45 colon, 14 gastric, 10 pseudomyxoma peritonei, 5 mesothelioma, 6 sarcoma) with PC treated with CRS+HIPEC from 2007 to December 2013 were retrospectively included. Tumor extent and location were assessed by the PCI and residual disease was recorded using the Completeness of Cytoreduction (CC) score. All clinical data were computed in univariate and multivariate analysis using survival as primary endpoint.
  
  
  RESULTS
  The PCI remains the most important factor concerning the long-term survival. Involved areas 4, 5 and 8 are more favorable in survival vs areas 9, 10 and 11, which predict a significantly worse outcome (p<0.002). Prognosis varies not only depending on how many peritoneal areas are involved but also on the location of the primary tumor.
  
  
  CONCLUSIONS
  We demonstrated that the involvement of different areas in the PCI system has a significant impact on the final prognosis and survival.
authors.affiliation: 1st Department of Surgical Oncology, Metaxa Cancer Hospital, Piraeus, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Spiliotis
authors.forename: Evgenia E
authors.initials: EE
authors.lastname: Halkia
authors.forename: Nausika
authors.initials: N
authors.lastname: Kalantzi
authors.forename: Stylianos
authors.initials: S
authors.lastname: Giassas
authors.forename: Evangelos
authors.initials: E
authors.lastname: Lianos
authors.forename: Elias
authors.initials: E
authors.lastname: Efstathiou
authors.forename: Paul H
authors.initials: PH
authors.lastname: Sugarbaker
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D006801:Humans; D006979:Hyperthermia, Induced; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents