接受腹膜恶性肿瘤细胞减灭术的患者剖腹手术时腹膜病变的形态学外观与病理评估时疾病的相关性：707 名患者的 PRECINCT 研究 I 期结果。
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.
发表日期：2024 Aug 26
作者：
Aditi Bhatt, Laurent Villeneuve, Armando Sardi, Amine Souadka, Alison Buseck, Brendan J Moran, Basma El Khannousi, Carlos Gonzalez de Pedro, Dario Baratti, Danielle Biacchi, David Morris, Daniel Labow, Edward A Levine, Faheez Mohamed, Gbadebo Adeleke, Gaurav Goswami, Isabelle Bonnefoy, Katherine Cummins Perry, Konstantinos I Votanopoulos, Loma Parikh, Marcello Deraco, Mohammad Alyami, Noah Cohen, Nazim Benzerdjeb, Nehal Shah, Nezha El Bahaoui, Nazanin Khajoueinejad, Pascal Rousset, Perry Shen, Shoma Barat, Sophia Stanford, Selma Khouchoua, Samantha Troob, Sakina Shaikh, Umut Sarpel, Vadim Gushchin, Vasanth Mark Samuel, Vahan Kepenekian, Paolo Sammartino, Olivier Glehen
来源：
ANNALS OF SURGICAL ONCOLOGY
摘要：
PRECINCT（常见和罕见腹膜肿瘤的腹膜传播模式和全身化疗的反应）是一项前瞻性、多中心、观察性研究。 PRECINCT 第一阶段的报告概述了经验丰富的腹膜恶性肿瘤中心记录手术腹膜癌指数 (sPCI) 的变化，以及形态不同的腹膜病变 (PL) 中病理证实的疾病的发生率。sPCI 以预先指定的格式记录，包括PL的形态外观。提供了六个预先指定的形态术语。比较手术和病理结果。从2020年9月至2021年12月，10个中心入组了707名患者。通常在两个中心记录形态学细节、具有最大结节的结构，以及每个区域在四个中心的最大肿瘤沉积物的确切尺寸。最常用的形态学术语是 3091 个区域（45.3%）为正常腹膜，2607 个区域（38.2%）为肿瘤结节，786 个区域（11.5%）为融合性疾病。病变评分为 2/3 的“肿瘤结节”中经病理证实的疾病发生率明显高于病变评分为 1 的“肿瘤结节”（63.1% vs. 31.5%；p < 0.001）。在接受新辅助化疗的患者中，经病理证实的疾病发生率与接受前期手术的患者没有显着差异[分别为 751 例 (47.7%) 和 532 例 (51.4%)； p = 0.069]。不同中心的 sPCI 记录具有异质性。 “肿瘤结节”中经病理证实的疾病发生率为49.2%。冰冻切片可以更广泛地用于这些病变，以帮助临床决策。指出了一项大规模研究，涉及不同形态外观的图片描述以及与病理结果的相关性。© 2024。作者。
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).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.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].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. The Author(s).