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Culture and Imaging of Ex Vivo Organotypic Pseudomyxoma Peritonei Tumor Slices from Resected Human Tumor Specimens

Culture and Imaging of Ex Vivo Organotypic Pseudomyxoma Peritonei Tumor Slices from Resected Human Tumor Specimens

Published on: December 9, 2022

External multicentre validation of pseudomyxoma peritonei PSOGI-Ki67 classification.

A Arjona-Sanchez¹, A Martinez-López², M T Moreno-Montilla³

¹Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain. Electronic address: https://twitter.com/alarjosan.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

|March 19, 2023

Summary

The Ki67 proliferation index refines the Pseudomyxoma Peritonei (PMP) classification, improving survival prediction for high-grade PMP (HG-PMP). This validated PSOGI-Ki67 classification is crucial for patient management.

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Area of Science:

Oncology
Pathology

Background:

Pseudomyxoma peritonei (PMP) is a rare malignancy.
Previous studies suggest Ki67 index addition to PSOGI PMP classification creates distinct HG-PMP subcategories with varied survival.
This study validates this new classification externally and multicentrically.

Purpose of the Study:

To externally and multicentrically validate the PSOGI-PMP classification incorporating the Ki67 proliferation index.
To assess the predictive accuracy of the new classification for overall survival (OS) and disease-free survival (DFS).

Main Methods:

Prospective analysis of a historical, international patient cohort (349 patients).
Ki67 proliferation index determined in high-grade PMP (HG-PMP) samples.
Statistical analysis included Cox proportional hazard models, Kaplan-Meier method, log-rank test, Harrel's C-index, and ROC curve analysis.

Main Results:

The PSOGI-Ki67 classification showed significant differences in 5-year OS (LG-PMP: 86%, HG-PMP≤15: 59%, HG-PMP>15: 38%, SRC-PMP: 42%) and DFS (LG-PMP: 49%, HG-PMP≤15: 35%, HG-PMP>15: 16%, SRC-PMP: 18%).
The classification demonstrated validated discrimination capability.
The p-value for both OS and DFS was < 0.0001, indicating high statistical significance.

Conclusions:

The PSOGI-Ki67 classification effectively discriminates and predicts OS and DFS in PMP patients.
It accurately divides the HG-PMP category into two prognostically distinct subcategories.
Routine incorporation of the Ki67 proliferation index into pathology reports for PMP patients is recommended.