Prognostic impact of the time interval between surgery and chemotherapy in advanced ovarian cancer: Analysis of prospective randomised phase III trials

Mahner, Sven; Eulenburg, Christine zu; Staehle, A.; Wegscheider, Karl; Reuß, Alexander; Pujade-Lauraine, Éric; Harter, Philipp; Ray‐Coquard, Isabelle; Pfisterer, Jacobus; Bois, Andreas du

doi:10.1016/j.ejca.2012.07.023

Cited by 110 publications

(88 citation statements)

References 25 publications

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“…SSI in ovarian cancer has previously been shown to be associated with increased postoperative mortality, increased risk of readmission, and longer TTC [8,9,19]. Additionally, delay of chemotherapy initiation following PS has been linked to decreased DFS and OS [20,21]. SSI following gynecologic cancer surgery is also associated with increased costs of care and SSIs in the setting of hysterectomy or bowel resection are reported to the Centers for Medicare and Medicaid Services (CMS) as a benchmark of institutional surgical quality [12,22].…”

Section: Discussionmentioning

confidence: 97%

Surgical site infection after primary surgery for epithelial ovarian cancer: Predictors and impact on survival

Tran

McGree

Weaver

et al. 2015

Gynecologic Oncology

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Section: Discussionmentioning

confidence: 97%

Surgical site infection after primary surgery for epithelial ovarian cancer: Predictors and impact on survival

Tran

McGree

Weaver

et al. 2015

Gynecologic Oncology

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“…Furthermore, length of ICU stay and time between surgery and chemotherapy were also longer in the RR group. Mahner et al 15 found that initiation of chemotherapy later than 19 days was associated with earlier death. This may be regarded as an advantage of DP over RR in providing earlier admission for chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Rectosigmoidectomy and Douglas Peritonectomy in the Management of Serosal Implants in Advanced-Stage Ovarian Cancer Surgery: Survival and Surgical Outcomes

Erkılınç¹,

Karataşlı²,

Demir³

et al. 2018

Int J Gynecol Cancer

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ObjectiveThis study aimed to evaluate the outcomes of rectosigmoid resection (RR) and Douglas peritonectomy (DP) on postoperative complications and survival in advanced-stage ovarian cancer surgery.Methods/MaterialsPatients who underwent optimal cytoreductive surgery including RR and DP between January 2007 and January 2013 were included. Patients with deeper invasion into the muscularis and mucosal layer reported in pathology results and colon wall injury necessitating suturing or resection suggesting invasion of implants into the colon wall were excluded. The decision for RR or DP was made according to the surgical team and patients’ preference. Resections were performed with the suspicion of colon wall invasion. The collected data were age, previous operations, preoperative cancer antigen 125 and albumin levels, surgical procedures, duration of surgery, tumor histology, recurrence, hyperthermic intraperitoneal chemotherapy, and length of hospital stay. Kaplan-Meir survival estimates were calculated and compared between the groups using the log-rank test. Cox proportional models were built to evaluate factors that affected disease-free and overall survival.ResultsAge, body mass index, preoperative cancer antigen 125 levels, albumin levels, and amount of ascites were similar between the groups. Neoadjuvant chemotherapy followed by interval debulking surgery was performed in 15% of both groups. End colostomy was performed in 23.7% of the RR group, and only 5.08% of the patients underwent diverting ileostomy procedures. There was no significant difference in terms of surgical complications between the groups. Recurrence occurred in the RR and DP groups at rates of 42% and 47%, respectively. Only primary debulking surgery had an effect on overall survival (odds ratio, 0.5; 95% confidence interval, 0.31–0.88). Overall survival and disease-free survival were similar in the RR and DP groups.ConclusionsDouglas peritonectomy showed similar survival and surgical outcomes to RR and provided shorter hospital stay and earlier admission to chemotherapy in the management of serosal implants during advanced-stage ovarian cancer surgery.

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“…Patients with ovarian cancer are recommended to receive adjuvant chemotherapy within 3 to 4 weeks of surgery, and unanticipated hospital admissions may delay initiation of such treatment. 19 In this study of patients with advanced-stage ovarian cancer, the 30-day readmission rate, after index admission for surgical cytoreduction, was 17.2%, and increased to more than 19% if multiple readmissions per patient were considered.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of 30-Day Hospital Readmission After Surgery for Advanced-Stage Ovarian Cancer in a Medicare Population

Eskander

Chang

Ziogas

et al. 2014

JCO

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Purpose To analyze rate, risk factors, and costs associated with 30-day readmission after ovarian cancer surgery. Patients and Methods The SEER-Medicare linked database (1992 to 2010) was used to evaluate readmission rates within 30 days of index surgery in patients with stage IIIC/IV ovarian, primary peritoneal, or fallopian tube cancer. Multivariable logistic regression was used to identify factors associated with readmission. Results Of 5,152 eligible patients, 1,003 (19.5%) were readmitted within 30 days of discharge. Mean patient age was 75 years. Diagnoses associated with readmission included infection (34.7%), dehydration (34.3%), ileus/obstruction (26.2%), metabolic/electrolyte derangements (23.1%), and anemia (12.3%). In multivariable analysis, year of discharge was significantly associated with 30-day readmission (1996 to 2000: odds ratio [OR], 1.32; 95% CI, 1.01 to 1.71; 2001 to 2005: OR, 1.58; 95% CI, 1.24 to 2.0; 2006 to 2010: OR, 1.73; 95% CI, 1.35 to 2.21; referent years 1992 to 1995), as were length of index hospital stay more than 8 days (OR, 1.39; 95% CI, 1.18 to 1.64) and discharge to a skilled nursing facility (OR, 1.3; 95% CI, 1.04 to 1.63). Patients readmitted within 30 days had a significantly greater 1-year mortality rate compared with patients not readmitted (41.1% v 25.1%, respectively; P < .001). The median cost of readmission hospital stay was $9,220 in year 2010 dollars, with a total cost of $9.3 million over the study period. Conclusion Early readmission after surgery for ovarian cancer is common. There is a significant association between 30-day readmission and 1-year mortality. These findings may catalyze development of targeted interventions to decrease early readmission, improve patient outcomes, and control health care costs.

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Prognostic impact of the time interval between surgery and chemotherapy in advanced ovarian cancer: Analysis of prospective randomised phase III trials

Cited by 110 publications

References 25 publications

Surgical site infection after primary surgery for epithelial ovarian cancer: Predictors and impact on survival

Surgical site infection after primary surgery for epithelial ovarian cancer: Predictors and impact on survival

Rectosigmoidectomy and Douglas Peritonectomy in the Management of Serosal Implants in Advanced-Stage Ovarian Cancer Surgery: Survival and Surgical Outcomes

Evaluation of 30-Day Hospital Readmission After Surgery for Advanced-Stage Ovarian Cancer in a Medicare Population

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