title: Computerized System for Staging Peritoneal Surface Malignancies.
abstract: BACKGROUND
  Peritoneal surface malignancies (PSMs) are usually staged using Sugarbaker's Peritoneal Cancer Index (PCI) and completeness of cytoreduction score (CC-s). Although these staging tools are essential for selecting patients and evaluating outcome after cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC), both scoring models lack some anatomic information, thus making staging laborious and unreliable. Maintaining Sugarbaker's original concepts, we therefore developed a computerized digital tool, including a new anatomic scheme for calculating PCI and CC-s corresponding closely to patients' real anatomy. Our new anatomic model belongs in a web-based application known as the PSM Staging System, which contains essential clinical and pathological data for the various PSMs currently treated.
  
  
  METHODS
  The new digital tool for staging PSM runs on a personal computer or tablet and comprises male and female colored anatomic models for the 13 endoabdominal regions, with borders defined according to real anatomic landmarks. A drag-and-drop tool allows users to compute the PCI and CC-s, making it easier to localize and quantify disease at diagnosis and throughout treatment, and residual disease after CRS.
  
  
  CONCLUSIONS
  Once tested online by registered users, our computerized application should provide a modern, shareable, comprehensive, user-friendly PSM staging system. Its anatomic features, along with the drag-and-drop tool, promise to make it easier to compare preoperative and postoperative PCIs, thus improving the criteria for selecting patients to undergo CRS plus HIPEC. By specifying the size, site, and number of residual lesions after CRS plus HIPEC, our digital tool should help stratify patients into outcome classes.
authors.affiliation: Dipartimento di Chirurgia P. Valdoni, Università di Roma Sapienza, Rome, Italy. paolo.sammartino@uniroma1.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Sammartino
authors.affiliation: Dipartimento di Chirurgia P. Valdoni, Università di Roma Sapienza, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Biacchi
authors.affiliation: Dipartimento di Chirurgia P. Valdoni, Università di Roma Sapienza, Rome, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Cornali
authors.affiliation: Dipartimento di Chirurgia P. Valdoni, Università di Roma Sapienza, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Accarpio
authors.affiliation: Dipartimento di Chirurgia P. Valdoni, Università di Roma Sapienza, Rome, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Sibio
authors.affiliation: Dipartimento di Chirurgia P. Valdoni, Università di Roma Sapienza, Rome, Italy.
authors.forename: Bernard
authors.initials: B
authors.lastname: Luraschi
authors.affiliation: Dipartimento di Chirurgia P. Valdoni, Università di Roma Sapienza, Rome, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Impagnatiello
authors.affiliation: Dipartimento di Chirurgia P. Valdoni, Università di Roma Sapienza, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Giorgio
mesh_terms: D003131:Combined Modality Therapy; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000145:classification* / Q000473:pathology* / Q000628:therapy; D011379:Prognosis