From the Ronnett to the PSOGI Classification System for Pseudomyxoma Peritonei: A Validation Study
Blanca Rufián-Andujar1,2, Francisca Valenzuela-Molina1,2, Sebastián Rufián-Peña1,2
1Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Av. Menendez Pidal, s/n, 14004, Cordoba, Spain.
Annals of Surgical Oncology
|January 20, 2021
Summary
The Peritoneal Surface Oncology Group International (PSOGI) classification, along with the Ronnett classification, effectively predicts survival in pseudomyxoma peritonei (PMP) patients. PSOGI demonstrated superior predictive accuracy for overall survival when adjusted for completeness of cytoreduction score (CCS).
Area of Science:
- Oncology
- Surgical Oncology
- Clinical Research
Background:
- Pseudomyxoma peritonei (PMP) management relies on classification systems for prognosis.
- The Ronnett classification is widely used, but a new Peritoneal Surface Oncology Group International (PSOGI) classification has emerged.
- Validation of the PSOGI classification's survival prediction capabilities is lacking.
Purpose of the Study:
- To validate the predictive capacity of the PSOGI classification against the Ronnett classification for patient survival.
- To compare the ability of both classifications to predict overall survival (OS) and disease-free survival (DFS) in PMP patients.
Main Methods:
- A cohort of 117 PMP patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) was analyzed.
- Cox proportional hazards regression and time-dependent ROC analyses were employed.
- Predictive performance for OS and DFS was assessed for both classification systems.
Main Results:
- Both Ronnett and PSOGI classifications showed significant differences in 5-year OS rates across histologic grades.
- Completeness of cytoreduction score (CCS) was a significant predictor of patient OS prognosis (p=0.006).
- Time-dependent ROC analysis indicated optimal prediction capacity, with AUCs of ~69% for OS and ~62% for DFS, adjusted for CCS and DFS.
Conclusions:
- Both the Ronnett and PSOGI classifications effectively predict survival in PMP patients.
- The PSOGI classification demonstrated superior predictive accuracy for overall survival compared to the Ronnett classification when adjusted for CCS.
