Morbidity and mortality associated with primary and repeat operations for ovarian cancer

Venesmaa, Pekka; Ylikorkala, Olavi

doi:10.1016/0020-7292(92)90941-b

Cited by 26 publications

(26 citation statements)

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“…These values are higher than those reported for either group 1 or group 2, but observed differences failed to achieve statistical significance (p = .28; p = .24). The rates observed for patients in group 3 compare favorably with reported series in which second effort surgery is accompanied by complication rates of 24%-34% (6,(12)(13)(14). Of greater interest is the finding that while the complication rate of 9.1% among 72 patients who did not undergo secondary cytoreductive efforts is lower than that of 21.4% observed among 28 patients in whom cytoreduction was performed, this difference does not achieve statistical significance (p = .09).…”

Section: Discussionsupporting

confidence: 62%

“…Absent from most of these reports, however, is a stratification of complications based on the extent of surgery per-formed. Among patients in groups 1 and 2 who did not have cytoreductive operations because no macroscopic disease was found, the major complication rates do not differ significantly from each other and compare favorably with a complication rate of 17% reported in a series of 222 patients who underwent second-look laparotomy without cytoreductive efforts (13).…”

Section: Discussionmentioning

confidence: 58%

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Second-look laparotomy in advanced ovarian cancer: A critical assessment of morbidity and impact on survival

Hempling

Wesolowski

Piver

1997

Annals of Surgical Oncology

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 58%

Second-look laparotomy in advanced ovarian cancer: A critical assessment of morbidity and impact on survival

Hempling

Wesolowski

Piver

1997

Annals of Surgical Oncology

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“…The 30-day mortality rate for women undergoing primary surgery for ovarian carcinoma ranged from 1-3%. [7][8][9][10] In addition, major morbidity as reported by these studies includes cardiac failure, wound dehiscence, hemorrhage requiring reoperation, and prolonged ileus. Considering that patients who undergo suboptimal debulking derive minimal benefit from surgical debulking, it would appear prudent to identify these patients preoperatively to offer them an alternate approach to the current standard of care.…”

mentioning

confidence: 99%

The utility of computed tomography scans in predicting suboptimal cytoreductive surgery in women with advanced ovarian carcinoma

Dowdy

Mullany

Brandt

et al. 2004

Cancer

169

100

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BACKGROUNDComputed tomography (CT) scans of the abdomen and pelvis may predict which patients with ovarian carcinoma can undergo optimal cytoreduction at primary surgery. Previous studies have demonstrated that patients with ovarian carcinoma had optimal cytoreduction rates ranging from 50–60%. The authors sought to determine whether these findings applied to a surgical practice with a higher rate of optimal debulking. A predictive model using CT scanning and CA 125 values would allow the authors to determine which patients would be more appropriately treated with neoadjuvant chemotherapy.METHODSPreoperative CT scans for patients with Stage III/IV ovarian carcinoma (according to the staging system of the International Federation of Gynecology and Obstetrics) who were treated between 1996 and 2001 were evaluated retrospectively by 2 radiologists for 17 criteria evaluating the extent of disease. Clinical data were extracted from medical records. Residual tumors measuring ≥ 1 cm were considered suboptimal. Logistic regression was used to evaluate which criteria correlated with optimal cytoreduction.RESULTSEighty‐seven patients were identified retrospectively who met entry criteria and had preoperative CT scans of sufficient diagnostic quality. Sixty‐two patients (71%) received optimal cytoreductive surgery and 45 (52%) required aggressive surgical procedures. In a multivariate model, only diffuse peritoneal thickening (DPT) independently predicted suboptimal surgical resection (P = 0.016). However, a model using both DPT and ascites on most CT scans had a positive predictive value of 68% and a sensitivity of 52% for predicting suboptimal cytoreduction.CONCLUSIONSThe presence of DPT and large‐volume ascites was associated with a very low rate of optimal cytoreduction (32%) in a surgical practice. These patients may be more appropriately treated with neoadjuvant chemotherapy followed by surgical cytoreduction. Cancer 2004. © 2004 American Cancer Society.

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“…Le pronostic aprè s la chirurgie est inversement corré lé à la taille du ré sidu tumoral et corré lé à l'expé rience du chirurgien [5,36]. La qualité de la cytoré duction initiale a un impact pré pondé rant sur la survie de la patiente â gé e et trè s â gé e (de plus de 80 ans) [35].…”

Section: Prise En Charge Chirurgicaleunclassified

Spécificité du cancer de l’ovaire chez la personne âgée

et al. 2008

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Ré sumé : Par ses caracté ristiques é pidé miologiques, le cancer de l'ovaire constitue un modè le oncogé riatrique par excellence. La surmortalité des patientes â gé es s'explique, au-delà de l'â ge chronologique seul, par une prise en charge souvent dé crite comme suboptimale, et par l'intervention de facteurs indé pendants, dé pisté s grâ ce à l'é valuation gé riatrique. En l'absence de donné es prospectives spé cifiques, les thé rapeutiques dites « standard » ont é té calqué es sur celles dé veloppé es chez les patientes plus jeunes, et il existe aujourd'hui une contradiction entre les ré sultats « rassurants » des diffé rents essais thé rapeutiques, analysé s en sousgroupes d'â ges, et les analyses de pratiques, plus abstentionnistes à la fois en termes de prise en charge chirurgicale et mé dicale. L'avè nement de la discipline oncogé riatrique a permis le dé veloppement ré cent d'é tudes cliniques « spé cifiques » et d'interface clinico-biologique, qui permettront à l'avenir une meilleure adaptation des straté gies thé rapeutiques. Mots clé s : Cancer de l'ovaireSujet â gé -É valuation gé riatriqueOvarian cancer in the elderly Abstract: Ovarian cancer is an excellent model in geriatric oncology because of its epidemiological characteristics. Increased age is associated with poorer prognoses, partly due to suboptimal treatments but also to independent factors detected during geriatric assessment. In the absence of specific prospective data, treatments validated in younger patients are considered standard in this heterogeneous and fragile population. Today, a contradiction exists between reassuring data obtained from the analysis of age subgroups in large therapeutic studies and analyses of real practice, frequently involving ongoing care using surgical and chemotherapeutic treatments. The advent of geriatric oncology has allowed the development of specific clinical studies and the establishment of a clinical/biological interface that will provide data for the improved adaptation of therapeutic strategies.

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Morbidity and mortality associated with primary and repeat operations for ovarian cancer

Cited by 26 publications

References 0 publications

Second-look laparotomy in advanced ovarian cancer: A critical assessment of morbidity and impact on survival

Second-look laparotomy in advanced ovarian cancer: A critical assessment of morbidity and impact on survival

The utility of computed tomography scans in predicting suboptimal cytoreductive surgery in women with advanced ovarian carcinoma

Spécificité du cancer de l’ovaire chez la personne âgée

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