scholarly journals Predictive value of the Age-Adjusted Charlson Comorbidity Index on perioperative complications and survival in patients undergoing primary debulking surgery for advanced epithelial ovarian cancer

2015 ◽  
Vol 138 (2) ◽  
pp. 246-251 ◽  
Author(s):  
Rudy S. Suidan ◽  
Mario M. Leitao ◽  
Oliver Zivanovic ◽  
Ginger J. Gardner ◽  
Kara C. Long Roche ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Predictive Value ◽  
Charlson Comorbidity Index ◽  
Perioperative Complications ◽  
Debulking Surgery ◽  
Primary Debulking Surgery ◽  
Comorbidity Index ◽  
Advanced Epithelial Ovarian Cancer

Primary Surgery or Interval Debulking for Advanced Epithelial Ovarian Cancer: Does It Matter?

2014 ◽  
Vol 24 (8) ◽  
pp. 1420-1428 ◽  
Author(s):  
Algirdas Markauskas ◽  
Ole Mogensen ◽  
René dePont Christensen ◽  
Pernille Tine Jensen
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Survival Benefit ◽  
Statistical Difference ◽  
Residual Disease ◽  
Operating Time ◽  
Debulking Surgery ◽  
Primary Debulking Surgery ◽  
Surgical Complexity ◽  
Advanced Epithelial Ovarian Cancer

ObjectiveThe aim of the present study was to investigate the surgical complexity, the postoperative morbidity, and the survival of the women after primary debulking surgery (PDS) and neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) for advanced epithelial ovarian cancer.Materials and MethodsWe consecutively included all patients who underwent debulking surgery at our institution between January 2007 and December 2012 for stages IIIc and IV of epithelial ovarian cancer.ResultsOf the 332 patients included, 165 (49.7%) underwent PDS, and 167 (50.3%) had NACT-IDS. Complete intraperitoneal cytoreduction was achieved in 70.9% after PDS and in 59.9 % after NACT-IDS. Residual disease of greater than 1 cm was left in 18.5% and 27.5% after PDS and NACT-IDS, respectively. Compared with NACT-IDS, PDS was associated with higher surgical complexity (P < 0.001), longer operating time (P < 0.001), greater blood loss (P < 0.001), longer hospitalization (P = 0.001), and a higher rate of major postoperative complications (26.7% vs 16.8%). No statistical difference in the median overall survival (OS) was found between the patients having complete cytoreduction and residual disease of 1 cm or less after NACT-IDS. Furthermore, no statistical difference in the median OS was found between the patients with macroscopic residual disease (≤1 vs >1 cm) after NACT-IDS. Patients with residual disease of greater than 1 cm after PDS had a median OS of 15 months.ConclusionsWe suggest that NACT-IDS may be a better treatment alternative for the group of highly selected women not suitable for PDS, where expected suboptimal cytoreduction does not have any appreciable survival benefit and exposes them for unnecessary risks. A substantial number of women who receive either PDS or NACT-IDS have greater than 1 cm of tumor tissue left after the operation. These women probably have no survival benefit from the operation, and future studies should focus on how to select these women preoperatively.

Using an evidence-based triage algorithm to reduce 90-day mortality after primary debulking surgery for advanced epithelial ovarian cancer

2019 ◽  
Vol 155 (1) ◽  
pp. 58-62 ◽  
Author(s):  
Deepa M. Narasimhulu ◽  
Amanika Kumar ◽  
Amy L. Weaver ◽  
Michaela E. McGree ◽  
Carrie L. Langstraat ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Evidence Based ◽  
Debulking Surgery ◽  
Primary Debulking Surgery ◽  
Advanced Epithelial Ovarian Cancer ◽  
Triage Algorithm
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