Diagnosis and staging
PCI
Peritoneal Cancer Index, Sugarbaker indexScore from 0 to 39 that quantifies how much tumour there is in the abdomen and how it is distributed across thirteen regions. It is the reference for deciding whether a complete cytoreduction is achievable.
It is calculated by dividing the abdomen into thirteen regions (nine quadrants of the cavity and four small bowel segments) and scoring the largest implant in each from 0 to 3: 0 no visible tumour, 1 under 5 mm, 2 between 5 mm and 5 cm, and 3 above 5 cm or with confluent nodules. The sum of the thirteen gives the final value.
The threshold above which it is considered high is not single: it depends on the tumour of origin. A pseudomyxoma with a PCI of 30 may be operable and a gastric carcinomatosis with a PCI of 12 may not. Location also counts, because diffuse involvement of the small bowel and its mesentery limits resection even when the total figure is moderate.
A reliable PCI is not obtained from imaging, which underestimates small implants, but in theatre or through a staging laparoscopy.
This explanation is intended as general information and does not replace a specialist assessment of an individual case.
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