Prognostic role of radiological peritoneal cancer index in malignant peritoneal mesothelioma: national cohort study

Silja A S Salo,Ilkka Ilonen,Sanna Laaksonen,Tuomo Rantanen,Eric Robinson,Marjukka Myllärniemi,Jarmo A Salo,Eila Lantto

doi:10.1038/s41598-020-70044-8

Abstract

Malignant peritoneal mesothelioma (MPeM) is a rare cancer of the mesothelial cells of the peritoneum. Computed tomography (CT) is considered the standard for first-line imaging of MPeM, diagnosis and risk stratification remains challenging. Peritoneal cancer index (PCI), as assessed by CT, is utilized in the prognostic assessment of other malignant intra-abdominal conditions; however, there is limited data concerning the utility of PCI in the diagnosis and workup of MPeM. We studied a retrospective cohort of all patients diagnosed with MPeM from 2000 to 2012 in Finland. CT and magnetic resonance imaging (MRI) were reviewed and scored by an experienced and blinded, board-certified abdominal radiologist. Additional clinical data and outcomes were obtained from Finnish Cancer Registry (FCR), the Workers’ Compensations Center (WCC), and Statistics Finland (SF). Abdominal CT or MRI was available for 53 of 90 patients. The median radiographic PCI was 25. PCI score was correlated with overall survival (p = 0.004, Exp(B) = 1.064, 95% CI 1.020–1.110). PCI score ≥ 30 was associated with worse survival (p = 0.002), while PCI ≤ 19 was associated with improved overall survival (p = 0.001). Our study indicates that radiological PCI is prognostic in MPeM and should be assessed during radiographic workup and integrated into clinical decision-making.

Highlights

Malignant peritoneal mesothelioma (MPeM) is a rare cancer of the mesothelial cells of the peritoneum
Peritoneal cancer index (PCI) is scored across 13 abdominal regions with the composite score reflecting both tumor size and distribution (Table 1)[10,11] The primary aim of our study was to evaluate the prognostic value of radiologic PCI and other clinical and radiographic features in a population-based cohort of patients presenting with MPeM over a 12-year period
The results of this study suggest that the radiological peritoneal cancer index has significant prognostic value in patients with MPeM

Summary

Introduction

Malignant peritoneal mesothelioma (MPeM) is a rare cancer of the mesothelial cells of the peritoneum. Peritoneal cancer index (PCI), as assessed by CT, is utilized in the prognostic assessment of other malignant intra-abdominal conditions; there is limited data concerning the utility of PCI in the diagnosis and workup of MPeM. Our study indicates that radiological PCI is prognostic in MPeM and should be assessed during radiographic workup and integrated into clinical decision-making. PCI is scored across 13 abdominal regions with the composite score reflecting both tumor size and distribution (Table 1)[10,11] The primary aim of our study was to evaluate the prognostic value of radiologic PCI and other clinical and radiographic features in a population-based cohort of patients presenting with MPeM over a 12-year period

Objectives

Methods

Results

Conclusion