Background: The PRECINCT (Pattern of peritoneal dissemination and REsponse to systemic Chemotherapy IN Common and uncommon peritoneal Tumors) is a prospective, multicenter, observational study. This report from phase I of PRECINCT outlines variations in recording the surgical peritoneal cancer index (sPCI) at experienced peritoneal malignancy centers and the incidence of pathologically confirmed disease in morphologically different peritoneal lesions (PL). Methods: The sPCI was recorded in a prespecified format that included the morphological appearance of PL. Six prespecified morphological terms were provided. The surgical and pathological findings were compared. Results: From September 2020 to December 2021, 707 patients were enrolled at 10 centers. The morphological details are routinely recorded at two centers, structure bearing the largest nodule, and exact size of the largest tumor deposit in each region at four centers each. The most common morphological terms used were normal peritoneum in 3091 (45.3%), tumor nodules in 2607 (38.2%) and confluent disease in 786 (11.5%) regions. The incidence of pathologically confirmed disease was significantly higher in ‘tumor nodules’ with a lesion score of 2/3 compared with a lesion score of 1 (63.1% vs. 31.5%; p < 0.001). In patients receiving neoadjuvant chemotherapy, the incidence of pathologically confirmed disease did not differ significantly from those undergoing upfront surgery [751 (47.7%) and 532 (51.4%) respectively; p = 0.069]. Conclusions: The sPCI was recorded with heterogeneity at different centers. The incidence of pathologically confirmed disease was 49.2% in ‘tumor nodules’. Frozen section could be used more liberally for these lesions to aid clinical decisions. A large-scale study involving pictorial depiction of different morphological appearances and correlation with pathological findings is indicated.

Correlation of Morphological Appearance of Peritoneal Lesions at Laparotomy and Disease at Pathological Assessment in Patients Undergoing Cytoreductive Surgery for Peritoneal Malignancy: Results of Phase I of the PRECINCT Study in 707 Patients / Bhatt, Aditi; Villeneuve, Laurent; Sardi, Armando; Souadka, Amine; Buseck, Alison; Moran, Brendan J; Khannousi, Basma El; De Pedro, Carlos Gonzalez; Baratti, Dario; Biacchi, Daniele; Morris, David; Labow, Daniel; Levine, Edward A; Mohamed, Faheez; Adeleke, Gbadebo; Goswami, Gaurav; Bonnefoy, Isabelle; Perry, Katherine Cummins; Votanopoulos, Konstantinos I; Parikh, Loma; Deraco, Marcello; Alyami, Mohammad; Cohen, Noah; Benzerdjeb, Nazim; Shah, Nehal; Bahaoui, Nezha El; Khajoueinejad, Nazanin; Rousset, Pascal; Shen, Perry; Barat, Shoma; Stanford, Sophia; Khouchoua, Selma; Troob, Samantha; Shaikh, Sakina; Sarpel, Umut; Gushchin, Vadim; Samuel, Vasanth Mark; Kepenekian, Vahan; Sammartino, Paolo; Glehen, Olivier. - In: ANNALS OF SURGICAL ONCOLOGY. - ISSN 1534-4681. - 31:13(2024). [10.1245/s10434-024-16035-9]

Correlation of Morphological Appearance of Peritoneal Lesions at Laparotomy and Disease at Pathological Assessment in Patients Undergoing Cytoreductive Surgery for Peritoneal Malignancy: Results of Phase I of the PRECINCT Study in 707 Patients

Biacchi, Daniele;Sammartino, Paolo;
2024

Abstract

Background: The PRECINCT (Pattern of peritoneal dissemination and REsponse to systemic Chemotherapy IN Common and uncommon peritoneal Tumors) is a prospective, multicenter, observational study. This report from phase I of PRECINCT outlines variations in recording the surgical peritoneal cancer index (sPCI) at experienced peritoneal malignancy centers and the incidence of pathologically confirmed disease in morphologically different peritoneal lesions (PL). Methods: The sPCI was recorded in a prespecified format that included the morphological appearance of PL. Six prespecified morphological terms were provided. The surgical and pathological findings were compared. Results: From September 2020 to December 2021, 707 patients were enrolled at 10 centers. The morphological details are routinely recorded at two centers, structure bearing the largest nodule, and exact size of the largest tumor deposit in each region at four centers each. The most common morphological terms used were normal peritoneum in 3091 (45.3%), tumor nodules in 2607 (38.2%) and confluent disease in 786 (11.5%) regions. The incidence of pathologically confirmed disease was significantly higher in ‘tumor nodules’ with a lesion score of 2/3 compared with a lesion score of 1 (63.1% vs. 31.5%; p < 0.001). In patients receiving neoadjuvant chemotherapy, the incidence of pathologically confirmed disease did not differ significantly from those undergoing upfront surgery [751 (47.7%) and 532 (51.4%) respectively; p = 0.069]. Conclusions: The sPCI was recorded with heterogeneity at different centers. The incidence of pathologically confirmed disease was 49.2% in ‘tumor nodules’. Frozen section could be used more liberally for these lesions to aid clinical decisions. A large-scale study involving pictorial depiction of different morphological appearances and correlation with pathological findings is indicated.
2024
Cytoreductive surgery; Morphology of peritoneal lesions; Peritoneal cancer index; Peritoneal metastases; Peritoneal surface malignancy; Surgical PCI
01 Pubblicazione su rivista::01a Articolo in rivista
Correlation of Morphological Appearance of Peritoneal Lesions at Laparotomy and Disease at Pathological Assessment in Patients Undergoing Cytoreductive Surgery for Peritoneal Malignancy: Results of Phase I of the PRECINCT Study in 707 Patients / Bhatt, Aditi; Villeneuve, Laurent; Sardi, Armando; Souadka, Amine; Buseck, Alison; Moran, Brendan J; Khannousi, Basma El; De Pedro, Carlos Gonzalez; Baratti, Dario; Biacchi, Daniele; Morris, David; Labow, Daniel; Levine, Edward A; Mohamed, Faheez; Adeleke, Gbadebo; Goswami, Gaurav; Bonnefoy, Isabelle; Perry, Katherine Cummins; Votanopoulos, Konstantinos I; Parikh, Loma; Deraco, Marcello; Alyami, Mohammad; Cohen, Noah; Benzerdjeb, Nazim; Shah, Nehal; Bahaoui, Nezha El; Khajoueinejad, Nazanin; Rousset, Pascal; Shen, Perry; Barat, Shoma; Stanford, Sophia; Khouchoua, Selma; Troob, Samantha; Shaikh, Sakina; Sarpel, Umut; Gushchin, Vadim; Samuel, Vasanth Mark; Kepenekian, Vahan; Sammartino, Paolo; Glehen, Olivier. - In: ANNALS OF SURGICAL ONCOLOGY. - ISSN 1534-4681. - 31:13(2024). [10.1245/s10434-024-16035-9]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1731444
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