The SAlzburg PEritoneal SUrface CAlculator (SAPESUCA): The First Web-Based Application for Peritoneal Surface Area...

Area of Science:

• Oncology
• Surgical Oncology
• Medical Informatics

Background:

• Peritoneal metastasis in colorectal cancer significantly worsens prognosis.
• Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) offers promising outcomes but lacks standardization.
• Accurate quantification of peritoneal surface area (PSA) is crucial for treatment planning and delivery.

Purpose of the Study:

• To introduce the first standardized tool, the SAlzburg PEritoneal SUrface CAlculator (SAPESUCA), for PSA quantification in CRS and HIPEC procedures.
• To enable precise adjustment of chemotherapeutic doses based on the resected and remaining PSA.
• To validate the SAPESUCA tool in a cohort of colorectal cancer patients.

Main Methods:

• SAPESUCA was developed using the R-Shiny framework.
• The algorithm integrates patient's body surface area and Peritoneal Cancer Index (PCI) data.
• Validation was performed on 23 colon cancer patients undergoing 27 oxaliplatin-based HIPEC treatments.

Main Results:

• SAPESUCA calculated a mean PSA of 18,613 cm² before and 13,681 cm² after CRS.
• The extent of peritonectomy correlated significantly with PCI score and postoperative morbidity.
• Simulated oxaliplatin doses showed significant differences before and after CRS (558 mg/m² vs. 409 mg/m²).

Conclusions:

• SAPESUCA is the first free, web-based application for standardized PSA determination post-CRS.
• The tool facilitates accurate chemotherapeutic dose adjustments tailored to the remaining PSA.
• Standardized PSA measurement is vital for optimizing HIPEC treatment efficacy in peritoneal carcinomatosis.