Complications and Survivorship Trends After Primary Debulking Surgery for Ovarian Cancer

J Surg Res. 2020 Feb;246:34-41. doi: 10.1016/j.jss.2019.08.027. Epub 2019 Sep 24.

Abstract

Background: We examined factors associated with postoperative complications, 1-year overall and cancer-specific survival after epithelial ovarian cancer (EOC) diagnosis.

Methods: Patients who underwent surgery for EOC between 2004 and 2013 were included. Multivariable models analyzed postoperative complications, overall survival, and cancer-specific survival.

Results: Among 5223 patients, surgical complications were common. Postoperative complications correlated with increased odds of overall and disease-specific survival at 1 y. Receipt of chemotherapy was similar among women with and without postoperative complications and was independently associated with a reduction in the hazard of overall and disease-specific death at 1-year. Extensive pelvic and upper abdomen surgery resulted in 2.26 times the odds of postoperative complication, but was associated with longer 1-year overall 0.53 (0.35, 0.82) and disease-specific survival 0.54 (0.34, 0.85).

Conclusions: Although extent of surgery was associated with complications, the survival benefit from comprehensive surgery offset the risk. Tailored surgical treatment for women with EOC may improve outcomes.

Keywords: Operative; Outcomes research; Ovarian neoplasms; Surgical procedures.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Cancer Survivors / statistics & numerical data*
  • Carcinoma, Ovarian Epithelial / mortality
  • Carcinoma, Ovarian Epithelial / surgery*
  • Cytoreduction Surgical Procedures / adverse effects*
  • Cytoreduction Surgical Procedures / methods
  • Disease-Free Survival
  • Female
  • Humans
  • Middle Aged
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / surgery*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Registries / statistics & numerical data
  • Retrospective Studies
  • Survival Rate / trends
  • Time Factors