The Potential Prognostic Impact of Associated Peritoneal Carcinomatosis in Patients with Stage II and III Epithelial Ovarian Cancer Who Had Upfront Complete Cytoreduction

BackgroundThe presence of metastatic peritoneal nodules in epithelial ovarian cancer (EOC) is considered a prognostic factor of both overall survival and disease-free survival. The goal of this study is to assess the potential prognostic effect of associated peritoneal carcinomatosis and PCI in stage II and III EOC patients after undergoing complete cytoreduction (CC score 0 or 1).Patients and MethodsThis is a retrospective cohort study including 50 high-grade serous EOC cases treated and followed up from 2012 and 2016. Twenty-three cases had peritoneal nodules at the time of exploration. PCI was assessed intraoperatively in each case. Twenty-seven cases had no peritoneal nodules (were given PCI 0).ResultsThe presence of peritoneal nodules, presence of ascites, and stage of the disease had statistically significant impact on overall survival, but with multivariate analysis, only presence of peritoneal nodules was associated with a statistically significant reduced overall survival (HR 6.192; 95% CI 1.248-30.720; P value 0.026). The presence of peritoneal nodules was associated with a statistically significant higher incidence of postoperative death (P value 0.038). PCI had no statistically significant impact on overall survival, disease-free survival, or incidence of postoperative death (within 30 days after surgery).ConclusionThe presence of peritoneal nodules had a statistically significant impact on overall survival and incidence of postoperative death. There was no statistically significant prognostic impact of PCI in stage II and III EOC patients who had complete cytoreduction.