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

Author:

Jäger Tarkan1ORCID,Schredl Philipp1,Neureiter Daniel2ORCID,Presl Jaroslav1ORCID,Tschann Peter3ORCID,Königsrainer Ingmar3,Pascher Andreas4,Emmanuel Klaus1,Regenbogen Stephan156ORCID,Ramspott Jan Philipp14ORCID

Affiliation:

1. Department of Surgery, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria

2. Institute of Pathology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria

3. Department of General and Thoracic Surgery, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria

4. Department for General, Visceral and Transplant Surgery, University Hospital Muenster, 48149 Muenster, Germany

5. Department for Trauma Surgery, BG Trauma Center Murnau, 82418 Murnau, Germany

6. Department for Trauma Surgery, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen am Rhein, Germany

Abstract

(1) Background: Peritoneal metastasized colorectal cancer is associated with a worse prognosis. The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) showed promising results in selected patients, but standardization is lacking so far. We present the first tool enabling standardized peritoneal surface area (PSA) quantification in patients undergoing CRS and HIPEC: The SAlzburg PEritoneal SUrface CAlculator (SAPESUCA). (2) Methods: SAPESUCA was programmed using the R-Shiny framework. The application was validated in 23 consecutive colon cancer patients who received 27 closed oxaliplatin-based HIPECs between 2016 and 2020. The programming algorithm incorporates the patient’s body surface area and its correlated peritoneal surface area (PSA) based on the 13 Peritoneal Cancer Index (PCI) regions. (3) Results: Patients’ median age was 56 years. Median PCI was 9. SAPESUCA revealed a mean PSA of 18,613 cm2 ± 1951 of all patients before compared to 13,681 cm2 ± 2866 after CRS. The Central PCI region revealed the highest mean peritonectomy extent (1517 cm2 ± 737). The peritonectomy extent correlated significantly with PCI score and postoperative morbidity. The simulated mean oxaliplatin dose differed significantly before and after CRS (558 mg/m2 ± 58.4 vs. 409 mg/m2 ± 86.1; p < 0.0001). (4) Conclusion: SAPESUCA is the first free web-based app for standardized determination of the resected and remaining PSA after CRS. The tool enables chemotherapeutic dose adjustment to the remaining PSA.

Funder

Österreichische Krebshilfe Salzburg, Salzburg, Austria

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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