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Factors associated with surgical morbidity of primary debulking in epithelial ovarian cancer.
Obstet Gynecol Sci 2020; 63(1):64-71OG

Abstract

Objective

Epithelial ovarian cancer (EOC) requires an aggressive surgical approach. The important part of literature on ovarian cancer surgery emphasize residual tumor and survival analyses. Morbidity issue keeps in background. Therefore, we aimed to report on morbidity of cytoreductive surgery for EOC in this study.

Methods

EOC patients who underwent primary debulking were evaluated. Intraoperative and postoperative complications that occurred within 30 days after the surgery and factors that affect morbidity were considered.

Results

The study involved 359 patients. Forty-six intraoperative complications occurred in 42 (11.6%) patients. Advanced stage and cancer antigen level of 125 were independently and significantly associated with operative complications (hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.01-2,73; P=0.044, and HR, 1.47; 95% CI, 1.05-2.06; P=0.025, respectively). The need for intensive care unit admission was significantly higher in patients with intraoperative complications (28.6% vs. 8.8%, P=0.001). Intraoperative and postoperative complication rates were significantly higher in extended surgery than in standard surgery (18.9%vs. 8.5%, P=0.005 and 38.7% vs. 10.9%, P<0.001, respectively). Intraoperative and postoperative transfusion need, hospital stay duration, and chemotherapy start day were also significantly higher in extended surgery than in standard surgery. Hundred postoperative complications occurred in 70 patients. Age, extended surgery, presence of ascites, and presence of operative complications were independently and significantly associated with postoperative complications.

Conclusion

Morbidity of extensive surgical approach should be kept in mind in ovarian cancer surgery aimed at leaving no residual tumor. Patient-based management with an appropriate preoperative evaluation may avoid morbidity of extended/extensive surgical approaches.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Keçioren Training and Research Hospital, University of Medical Sciences, Ankara, Turkey.Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey.Department of Obstetrics and Gynecology, Keçioren Training and Research Hospital, University of Medical Sciences, Ankara, Turkey.Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey.Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey.Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31970129

Citation

Günakan, Emre, et al. "Factors Associated With Surgical Morbidity of Primary Debulking in Epithelial Ovarian Cancer." Obstetrics & Gynecology Science, vol. 63, no. 1, 2020, pp. 64-71.
Günakan E, Tohma YA, Tunç M, et al. Factors associated with surgical morbidity of primary debulking in epithelial ovarian cancer. Obstet Gynecol Sci. 2020;63(1):64-71.
Günakan, E., Tohma, Y. A., Tunç, M., Akıllı, H., Şahin, H., & Ayhan, A. (2020). Factors associated with surgical morbidity of primary debulking in epithelial ovarian cancer. Obstetrics & Gynecology Science, 63(1), pp. 64-71. doi:10.5468/ogs.2020.63.1.64.
Günakan E, et al. Factors Associated With Surgical Morbidity of Primary Debulking in Epithelial Ovarian Cancer. Obstet Gynecol Sci. 2020;63(1):64-71. PubMed PMID: 31970129.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with surgical morbidity of primary debulking in epithelial ovarian cancer. AU - Günakan,Emre, AU - Tohma,Yusuf Aytaç, AU - Tunç,Mehmet, AU - Akıllı,Hüseyin, AU - Şahin,Hanifi, AU - Ayhan,Ali, Y1 - 2019/12/31/ PY - 2019/07/05/received PY - 2019/09/04/revised PY - 2019/09/09/accepted PY - 2020/1/24/entrez PY - 2020/1/24/pubmed PY - 2020/1/24/medline KW - Cytoreduction KW - Epithelial ovarian cancer KW - Morbidity KW - Ovarian cancer KW - Primary debulking SP - 64 EP - 71 JF - Obstetrics & gynecology science JO - Obstet Gynecol Sci VL - 63 IS - 1 N2 - Objective: Epithelial ovarian cancer (EOC) requires an aggressive surgical approach. The important part of literature on ovarian cancer surgery emphasize residual tumor and survival analyses. Morbidity issue keeps in background. Therefore, we aimed to report on morbidity of cytoreductive surgery for EOC in this study. Methods: EOC patients who underwent primary debulking were evaluated. Intraoperative and postoperative complications that occurred within 30 days after the surgery and factors that affect morbidity were considered. Results: The study involved 359 patients. Forty-six intraoperative complications occurred in 42 (11.6%) patients. Advanced stage and cancer antigen level of 125 were independently and significantly associated with operative complications (hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.01-2,73; P=0.044, and HR, 1.47; 95% CI, 1.05-2.06; P=0.025, respectively). The need for intensive care unit admission was significantly higher in patients with intraoperative complications (28.6% vs. 8.8%, P=0.001). Intraoperative and postoperative complication rates were significantly higher in extended surgery than in standard surgery (18.9%vs. 8.5%, P=0.005 and 38.7% vs. 10.9%, P<0.001, respectively). Intraoperative and postoperative transfusion need, hospital stay duration, and chemotherapy start day were also significantly higher in extended surgery than in standard surgery. Hundred postoperative complications occurred in 70 patients. Age, extended surgery, presence of ascites, and presence of operative complications were independently and significantly associated with postoperative complications. Conclusion: Morbidity of extensive surgical approach should be kept in mind in ovarian cancer surgery aimed at leaving no residual tumor. Patient-based management with an appropriate preoperative evaluation may avoid morbidity of extended/extensive surgical approaches. SN - 2287-8572 UR - https://www.unboundmedicine.com/medline/citation/31970129/Factors_associated_with_surgical_morbidity_of_primary_debulking_in_epithelial_ovarian_cancer L2 - https://ogscience.org/DOIx.php?id=10.5468/ogs.2020.63.1.64 DB - PRIME DP - Unbound Medicine ER -