Saved Results

No results saved yet.

Enter a patient name and hit Save on a result.

Clinical calculator summary

Peritoneal Cancer Index (PCI)

A 0-39 score that sums the largest visible implant category across 13 peritoneal regions.

Evidence-based context for fast calculator use

Purpose:
Standardize documentation of macroscopic peritoneal disease burden.
Population:
Patients with peritoneal metastases or a peritoneal surface malignancy undergoing radiologic, laparoscopic, or operative assessment.
Factors:
Complete 13-region assessment, Largest implant per region, Confluent disease, Assessment modality, Primary tumor context
Reference:
Jacquet and Sugarbaker, Cancer Treat Res. 1996;82:359-374.
HomePeritoneal Carcinomatosis Index (PCI)
Pin your most used calculators here by clicking the star in the dropdown.

Peritoneal Carcinomatosis Index (PCI)

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

Required regional assessment. LS-0 means the region was examined and no visible tumor was found.

PCI region map

Score 13 regions before CRS-HIPEC discussion

PCI vs CC score guide
1

Right upper

2

Epigastrium

3

Left upper

8

Right flank

0

Central

4

Left flank

7

Right lower

6

Pelvis

5

Left lower

Regions 0-8 cover the abdominopelvic grid. Regions 9-12 capture small-bowel involvement, which can strongly affect complete cytoreduction feasibility.

Small bowel regions

9Upper jejunum
10Lower jejunum
11Upper ileum
12Lower ileum

Lesion-size score

LS-0No visible tumor
LS-1Largest implant ≤5 mm
LS-2Largest implant >5 mm and ≤50 mm
LS-3>5 cm or confluent disease

Use before referral

Summarize tumor distribution for a peritoneal surface malignancy or tumor board review.

Flag small bowel

A modest total PCI can still be challenging when bowel or mesentery disease is extensive.

Pair with CC score

PCI describes burden before cytoreduction; CC score documents residual disease after surgery.

Clinical Context & Background

The Peritoneal Cancer Index (PCI) quantifies macroscopic peritoneal disease burden by summing lesion-size scores across 13 abdominopelvic and small-bowel regions. Every region must be explicitly assessed; LS-0 means the region was examined and no visible tumor was found, not that the region was unassessed.
For each region, score the greatest diameter of visible peritoneal implants. Use LS-1 for implants up to and including 5 mm, LS-2 for implants greater than 5 mm and up to and including 50 mm, and LS-3 for implants greater than 50 mm or confluent disease. Implant number does not change the regional score.
PCI is a disease-burden descriptor, not a universal CRS-HIPEC eligibility rule. Radiologic, laparoscopic, and operative assessments are not interchangeable, and clinical thresholds vary by primary tumor, distribution, biology, resectability, treatment intent, and center expertise.
Formula Logic
PCI = sum of LS-0 to LS-3 scores for regions 0 through 12. Valid total: 0 to 39.

Reference Data

Lesion-size scoreRequired regional assessment
LS-0No visible tumor in an explicitly assessed region
LS-1Largest implant ≤5 mm
LS-2Largest implant >5 mm and ≤50 mm
LS-3Largest implant >50 mm or confluent disease
Total PCISum all 13 regional scores; range 0-39

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use to document peritoneal disease distribution during structured imaging, laparoscopy, laparotomy, referral, or multidisciplinary review.
  • Record all 13 regions explicitly and identify whether the score is radiologic, laparoscopic, or operative.
  • Use the largest visible implant in each region; confluent disease is LS-3 regardless of individual nodule size.

How To Interpret

  • The total PCI ranges from 0 to 39 and describes macroscopic disease burden and distribution.
  • The original PCI does not define universal low, moderate, or high categories.
  • Interpretation and treatment thresholds are disease-specific and must account for distribution, biology, resectability, and assessment modality.

What To Do Next

  • Document the assessment modality and separately describe small-bowel/mesenteric involvement, extra-peritoneal disease, performance status, and anticipated resectability.
  • Use the PCI versus CC score guide when distinguishing pre-cytoreduction disease burden from post-cytoreduction residual disease.
  • Discuss treatment implications in a peritoneal surface malignancy multidisciplinary team rather than applying a universal PCI cutoff.

Limitations

  • Do not use an unassessed region as LS-0.
  • Do not treat radiologic, laparoscopic, and operative PCI as interchangeable.
  • Do not use PCI alone to determine CRS, HIPEC, prognosis, or treatment eligibility.

Validated Population

Originally developed for peritoneal carcinomatosis staging and now used across peritoneal surface malignancies; disease-specific interpretation is required.

Clinical Example

A PCI of 12 documents the sum and distribution of regional disease. It does not by itself define low or moderate burden or determine CRS-HIPEC eligibility.

PCI vs CC ScoreCompare disease burden with residual disease after cytoreduction.Colorectal Calculator HubReview related colorectal decision support.Fong Clinical Risk ScoreReview colorectal liver metastasis recurrence-risk context.Modified Glasgow Prognostic ScoreAdd systemic inflammation and nutritional context when appropriate.Stage II Colon RiskReview high-risk colon cancer features.

Calculation verification history

Verified

  1. : Production browser revalidation

    • Three source-backed cases passed through all thirteen visible region controls at PCI totals 0, 18, and 39.
    • Total and small-bowel subscores matched the Sugarbaker lesion-size sum exactly without unsupported universal risk bands or treatment cutoffs.
    • No unexpected N/A, stale control, literal undefined/null value, or browser-console error was observed.
    Download latest production check (Excel)

    Case-level evidence is retained in validation/browser-revalidation/peritoneal-carcinomatosis-index-pci-2026-08-03.json.

  2. : Production browser validation

    • Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 12 visible submissions.
    • Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
    • Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.

    Case-level production evidence is retained in validation/browser-production/peritoneal-carcinomatosis-index-pci.json.

  3. : Full validation test

    • Checked all 13 regions, LS-0 to LS-3 boundaries, representative totals from 0 to 39, and incomplete or invalid assessments.

  4. : Correction

    • Required an explicit valid selection for every region instead of silently treating unassessed regions as LS-0.
    • Corrected LS-1 to include exactly 5 mm and LS-2 to include exactly 50 mm.
    • Removed unsupported universal tumor-burden categories and the uncited small-bowel warning threshold.

    Included in the current validation report.

Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.

Found a possible issue? Report it to improve this calculator

Share This Calculator

Share:

Related Tools

Fong Clinical Risk Score (CRS)Modified Glasgow Prognostic Score (mGPS)ASCO 2022 Stage II Colon High-Risk Feature Assessment

Frequently Asked Questions

What does the PCI score measure?

PCI records macroscopic peritoneal disease burden by scoring the largest visible implant in each of 13 regions.

What if a region cannot be assessed?

Do not enter LS-0. LS-0 means the region was examined and no visible tumor was found. An incomplete assessment should be documented as incomplete rather than assigned a total PCI.

Is there one universal PCI cutoff for CRS-HIPEC?

No. The original score has no universal low, moderate, or high categories, and treatment thresholds vary by disease and clinical context.

How is PCI different from the CC score?

PCI describes disease burden before or during exploration. Completeness of Cytoreduction score describes visible residual disease after cytoreductive surgery.

What is the PCI score range?

The total ranges from 0 to 39. Each of 13 explicitly assessed regions receives an LS-0 to LS-3 score based on the largest visible implant or confluent disease.

Are radiologic, laparoscopic, and operative PCI interchangeable?

No. Record the assessment modality because visibility and access differ, and interpret the resulting PCI within that modality and disease context.

Evidence-based oncology decision support. Verify with clinical guidelines.