Complications and Survivorship Trends After Primary Debulking Surgery for Ovarian Cancer

Abstract

Background:We examined factors associated with postoperative complications, 1-year overall and cancer-specific survival after epithelial ovarian cancer (EOC) diagnosis.Methods: Patients who underwent surgery for EOC between 2004 and 2013 were included. Multivariable models analyzed postoperative complications, overall survival, and cancer-specific survival.Results: Among 5223 patients, surgical complications were common. Postoperative complications correlated with increased odds of overall and disease-specific survival at 1 y. Receipt of chemotherapy was similar among women with and without postoperative complications

The Influence of the Preoperative Status on the Risk of Postoperative Complications After Cytoreductive Surgery for Advanced-stage Ovarian Cancer

“…Therefore, attention was focused on determining which other factors might influence the risks of postoperative complications and how can they be controlled in order to minimize the perioperative morbidity. An interesting study conducted on this issue came to demonstrate that although extended pelvic and upper abdominal resections were associated with a double rate of complications when compared to standard pelvic resections this type of surgery significantly increased the disease free and overall survival (18). The study included 5,223 women submitted to debulking surgery for advanced stage ovarian cancer, with a median age of 62 years (range=52-73 years).…”

“…Among these cases, the rate of early postoperative morbidity (within the first 30 days) was of 26.1%, while the rate of postoperative mortality was of 3% and was significantly associated with age, black race, type of insurance, comorbidity burden, unscheduled admission, advanced stage (FIGO stage IV) of disease) and extensive surgical procedures. Among the comorbidities that impacted the rate of postoperative morbidity, the strongest influence was observed for chronic obstructive pulmonary disease, chronic heart failure, renal function impairment as well as obesity; however, the onset of the adjuvant chemotherapeutic protocol was not influenced by the apparition of postoperative complications (18). Another similar study conducted on this theme in the United States of America and published this year came to demonstrate that association of a higher rate of preoperative comorbidities, presence of ascites, increased age, higher number of platelets, necessity of administration of preoperative or postoperative transfusions as well as a higher length of surgery and disseminated lesions are associated with a more difficult postoperative evolution and an increased length of hospital in stay; in the meantime the authors underlined the fact that a longer period of hospital in stay can also increase patients morbidity as well as the overall costs (19).…”

“…Another interesting aspect is the one related to the longterm outcomes of these patients; the question which should be raised is whether patients submitted to highly morbid surgical procedure will finally benefit from the radicality of their resections and will experience long term survival rates. Therefore, the American authors recently demonstrated that although patients developing postoperative complications had a lower rate of survival at one year follow up (the one year overall survival being of 77.2% for patients which reported postoperative complications, and 89% for patients with uneventful postoperative evolution) and despite the association between extended resections and postoperative complications; the overall survival of patients submitted to extended visceral resections was significantly improved at one year (18). In this respect, other factors influencing the poorer outcomes of patients developing postoperative complications should be investigated (28)(29)(30)(31).…”

Lin28A Regulates Stem-like Properties of Ovarian Cancer Cells by Enriching RAN and HSBP1 mRNA and Up-regulating its Protein Expression

“…International Publisher 70%-90% [5,6]. At present, the main treatments for OC patients include surgery, platinum and paclitaxel combined chemotherapy, Cetuximab, a monoclonal antibody that inhibits epidermal growth factor receptor (EGFR) [7][8][9]. The emergence of PARP inhibitors has brought new hope to people, but only 10-20% of patients with OC carry BRCA1/2 mutation [9][10][11][12].…”

Fatores que influenciam a citorredução primária e impacto no câncer de ovário no estádio III

“…O balanço entre os benefícios de se tentar uma cirurgia radical e o risco de complicações graves constitui-se em um dos principais dilemas na decisão sobre o procedimento inicial no câncer de ovário. Há no entanto, a tendência na literatura atual a aceitar que a extensão da cirurgia beneficia o desfecho das pacientes independente do risco de complicações associado ao procedimento (XU et al, 2020 (KEHOE et al, 2015;ONDA et al, 2020;VERGOTE et al, 2010). Esta é uma evidência que a cirurgia pode ser um fator adicional para limitar o início do tratamento quimioterápico em pacientes com tumores avançados do ovário.…”