Risk Factors for Surgical Complications in Ovarian Cancer


Preoperative albumin level and number of extended cytoreductive procedures in ovarian cancer patients predicted the likelihood of surgical complications.

A woman’s preoperative albumin level and the number of extended cytoreductive procedures performed were found to be the strongest predictors of perioperative morbidity when undergoing surgery for ovarian cancer, according to the results of a retrospective analysis published in Gynecologic Oncology.

“Given that those women who require multiple extended procedures are at highest risk, these data suggest that alternative treatment strategies should be considered in women who may require extended cytoreductive surgery,” wrote Sonali Patankar, MD, of Columbia University College of Physicians and Surgeons in New York, and colleagues.

According to the researchers, cytoreduction for ovarian cancer is associated with substantial morbidity, and in this analysis, they sought to identify if certain subgroups of patients may benefit from alternative treatments.

The researchers looked at 2,870 women from the National Surgical Quality Improvement Program database who had undergone surgery for ovarian cancer between 2005 and 2012.

Looking at outcomes by age, the researchers found that the perioperative complication rate was 9.5% in women aged less than 50 years, 13.4% in women aged 60 to 69 years, and 14.6% in women aged 70 years or older (P < .0001). In addition, women aged 70 years or older were at increased risk for prolonged hospitalization, non-routine discharge, transfusion, and death compared with patients aged less than 50 years.

The researchers conducted a multivariable analysis corrected for clinical and demographic characteristics and found that the number of extended cytoreductive procedures performed was consistently associated with worse perioperative morbidity. Specifically, three or more procedures were associated with four times the relative risk (RR) for any complication, five times the risk for severe complications, and more than three times the risk for wound complications. Undergoing more than three procedures was also associated with prolonged hospitalization (RR = 4.68; 95% confidence interval [CI], 3.22–6.80), non-routine discharge (RR = 2.82; 95% CI, 1.11–7.19), and transfusion (RR = 3.15; 95% CI, 2.14–4.63).

In the multivariable analysis, preoperative albumin levels were also found to be significantly associated with any complication, severe complications, prolonged hospitalization, non-routine discharge, transfusion, and reoperation (P < .05 for all).

“Somewhat surprisingly, neither age nor functional status was independently associated with morbidity or mortality,” the researchers noted.

Recent Videos
Brian Slomovitz, MD, MS, FACOG discusses the use of new antibody drug conjugates for treating patients with various gynecologic cancers.
Developing novel regimens may continue to improve survival outcomes of patients with advanced cervical cancer following the FDA approval of pembrolizumab and chemoradiation, says Jyoti S. Mayadev, MD.
Treatment with pembrolizumab plus chemoradiation appears to be well tolerated with no detriment to quality of life among those with advanced cervical cancer.
Jyoti S. Mayadev, MD, says that pembrolizumab in combination with chemoradiation will be seamlessly incorporated into her institution’s treatment of those with FIGO 2014 stage III to IVA cervical cancer following the regimen’s FDA approval.
Domenica Lorusso, MD, PhD, says that paying attention to the quality of chemoradiotherapy is imperative to feeling confident about the potential addition of pembrolizumab for locally advanced cervical cancer.
Guidelines from the Society of Gynecologic Oncology may help with managing the ongoing chemotherapy shortage in the treatment of patients with gynecologic cancers, according to Brian Slomovitz, MD, MS, FACOG.
Interim data reveal favorable responses in patients with low-grade serous ovarian cancer treated with avutometinib plus defactinib, according to Susana N. Banerjee, MD.
Brian Slomovitz, MD, MS, FACOG, notes that sometimes there is a need to substitute cisplatin for carboplatin, and vice versa, to best manage gynecologic cancers during the chemotherapy shortage.
Findings from the phase 3 MIRASOL trial support mirvetuximab soravtansine as a standard treatment option for platinum-resistant ovarian cancer, according to Ritu Salani, MD.
Trastuzumab deruxtecan appears to elicit ‘impressive’ responses among patients with HER2-positive gynecologic cancers regardless of immunohistochemistry in the phase 2 DESTINY-PanTumor02 trial.
Related Content