Maximal Effort Cytoreduction in Epithelial Ovarian Cancer: Perioperative Complications and Survival Outcomes from a Retrospective Cohort
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Definitions
2.3. Statistical Analysis
3. Results
3.1. Patient and Tumor Characteristics
3.2. Tumor Dissemination, Extent of Resectability and Perioperative Complications
3.3. Survival Rates
4. Discussion
4.1. Strengths and Limitations of Our Study
4.2. Implications for Future Research
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Age | 62 (23–84) |
---|---|
Stage | |
IIIb | 4 |
IIIc | 76 |
IVa | 23 |
IVb | 4 |
Histological grade | |
Low | 11 |
High | 96 |
Histological type | |
Serous | 90 |
Mucinous | 2 |
Clear cell | 3 |
Endometrioid | 3 |
Carcinosarcoma | 9 |
Interval debulking | 20 |
Primary debulking | 87 |
Ascites | |
None | 24 |
<500 mL | 40 |
>500 mL | 42 |
ECOG 0/1 | 88 |
ECOG 2/3 | 19 |
Hysterectomy | 106 |
Omentectomy | 105 |
Pelvic lymphadenectomy | 78 |
Paraortic lymphadenectomy | 35 |
Large bowel resection | 31 |
Large bowel stoma | 16 |
Small bowel resection | 10 |
Small bowel stoma | 12 |
Splenectomy | 26 |
Cholocystectomy | 3 |
Sphenoid liver resection | 9 |
Diaphragmatic stripping | 34 |
Diaphragmatic resection | 18 |
Extent of debulking | |
R0 | 81 |
R1 | 20 |
R2 | 6 |
Parameter | Progression Free Survival (95% CI) | Overall Survival Months (95% CI) | Hazard Ratio 95% CI PFS | Hazard Ratio 95% CI OS |
---|---|---|---|---|
Stage | ||||
IIIb | 34.00 (12.14, 55.86) | 85.00 (26.85, 143.15) | Ref | Ref |
IIIc | 31.21 (23.19, 39.23) | 42.21 (33.55, 50.87) | 1.29 (0.78, 2.16) | 1.04 (0.60, 1.71) |
IVa | 21.05 (14.70, 27.39) | 46.95 (27.29, 66.15) | 1.95 (0.60, 6.29) | 0.41 (0.10, 1.69) |
IVb | 14.00 (2.00, 29.84) | 12.25 (2.00, 25.21 | 0.73 (0.23, 2.33) | 3.46 (1.23, 9.75) |
Grade of differentiation | ||||
Low grade | 26.25 (11.94, 40.56) | 48.20 (26.96, 69.44) | Ref | Ref |
High grade | 25.77 (20.12, 31.41) | 46.82 (35.44, 58.20) | 1.14 (0.75, 1.73) | 1.16 (0.78, 1.73) |
Surgical complexity | ||||
Intermediate | 31.59 (23.59, 39.59) | 42.93 (31.04, 54.82) | Ref | Ref |
High | 24.74 (15.60, 33.88) | 46.51 (34.16, 58.86) | 1.23 (0.75, 2.02) | 0.78 (0.47, 1.29) |
Setting of operation | ||||
Primary | 23.15 (14.40, 31.90) | 53.75 (39.98, 67.52) | Ref | Ref |
Interval | 28.13 (21.15, 35.11) | 35.15 (24.21, 46.09) | 1.11 (0.65, 1.89) | 1.45 (1.08, 2.48) |
Level of resection | ||||
R0 | 28.99 (22.17, 35.81) | 46.14 (35.23, 57.05) | Ref | Ref |
R1 | 24.91 (15.21, 34.61) | 47.92 (27.85, 67.98) | 1.07 (0.62, 1.84) | 0.96 (0.58, 1.60) |
Patient age | ||||
<70 years | 26.94 (21.22, 32.66) | 45.39 (34.89, 55.89) | Ref | Ref |
>70 years | 29.48 (16.24, 42.72) | 45.60 (26.16, 56.04) | 1.05 (0.63, 1.76) | 1.05 (0.65, 1.71) |
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Haidopoulos, D.; Pergialiotis, V.; Zachariou, E.; Sapantzoglou, I.; Thomakos, N.; Stamatakis, E.; Alexakis, N. Maximal Effort Cytoreduction in Epithelial Ovarian Cancer: Perioperative Complications and Survival Outcomes from a Retrospective Cohort. J. Clin. Med. 2023, 12, 622. https://doi.org/10.3390/jcm12020622
Haidopoulos D, Pergialiotis V, Zachariou E, Sapantzoglou I, Thomakos N, Stamatakis E, Alexakis N. Maximal Effort Cytoreduction in Epithelial Ovarian Cancer: Perioperative Complications and Survival Outcomes from a Retrospective Cohort. Journal of Clinical Medicine. 2023; 12(2):622. https://doi.org/10.3390/jcm12020622
Chicago/Turabian StyleHaidopoulos, Dimitrios, Vasilios Pergialiotis, Eleftherios Zachariou, Ioakim Sapantzoglou, Nikolaos Thomakos, Emmanouil Stamatakis, and Nikolaos Alexakis. 2023. "Maximal Effort Cytoreduction in Epithelial Ovarian Cancer: Perioperative Complications and Survival Outcomes from a Retrospective Cohort" Journal of Clinical Medicine 12, no. 2: 622. https://doi.org/10.3390/jcm12020622