Back to Journals » International Journal of Women's Health » Volume 11

Predictive model for major complications after extensive abdominal surgery in primary advanced ovarian cancer

Authors Llueca A, Serra A, Maiocchi K, Delgado K, Jativa R, Gomez L, Escrig J

Received 11 October 2018

Accepted for publication 12 December 2018

Published 7 March 2019 Volume 2019:11 Pages 161—167

DOI https://doi.org/10.2147/IJWH.S190493

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Dr Everett Magann


Antoni Llueca,1–3 Anna Serra,1–3 Karina Maiocchi,2,4 Katty Delgado,2,5 Rosa Jativa,2,6 Luis Gomez,2,4 Javier Escrig3–5

On behalf of the MUAPOS working group (Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery)

1Department of Obstetrics and Gynaecology, University General Hospital of Castellon, Castellon, Spain; 2Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellon, Castellon, Spain; 3Department of Medicine, University Jaume I (UJI), Castellon, Spain; 4Department of General Surgery, University General Hospital of Castellon, Castellon, Spain; 5Department of Radiology, 6Department of Anaesthesiology, University General Hospital of Castellon, Castellon, Spain

Background: Surgery for advanced ovarian cancer (AOC) frequently results in serious complications. The present study aimed to determine the importance of various factors and complications in cytoreductive surgery for AOC.
Patients and methods: The present study included 90 patients with AOC who underwent primary cytoreductive surgery in a single institution from January 2013 to August 2017. Demographic and clinicopathologic characteristics, surgical procedures, residual disease, and follow-up data were analyzed. Cytoreductive surgery was defined as complete (no residual tumor), optimal (residual tumor 1 cm in diameter). Grade III–IV complications were considered major. Patients were evaluated every 3–6 months.
Results: Surgical outcome was complete in 75 (82%), optimal in 5 (6%), and suboptimal in 11 (12%) patients. Major complications occurred in 28 (31%) patients. Independent risk factors for major complications were ≥five visceral resections, rectosigmoid resection, glissectomy, and pelvic peritonectomy. A score created by weighing the multivariate OR for each risk factor correctly predicted major complications in 67% of cases. A score cut-off of >2 discriminated between patients with and without complications in 79% of cases (95% CI: 70%–86%, P<0.001). Adjuvant chemotherapy was performed as planned in 67 patients (74%), including 50 (75%) without major complications and 17 (25%) with major complications.
Conclusion: Risk factors for major complications in cytoreductive surgery for AOC are ≥five visceral resections, rectosigmoid resection, glissectomy, and pelvic peritonectomy. Our model predicts morbidity based on major and minor classifications of complications.

Keywords: advanced ovarian cancer, debulking surgery, peritoneal cancer index, residual tumor, complications, predictive model, carcinomatosis, cytoreductive surgery, morbidity

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]