The purpose of this study is to determine whether or not substantial postoperative problems have a negative effect on survival for patients with advanced ovarian cancer who have undergone cytoreductive surgery. Patients with stage IIIC-IV FIGO ovarian cancer who had primary debulking surgery (PDS), early interval debulking surgery (IDS) following 3-4 cycles of neoadjuvant chemotherapy, or delayed debulking surgery (DDS) following 6 cycles of neoadjuvant chemotherapy and minimal or no residual disease were included in this retrospective multicenter study. Major surgical complications (≥Grade 3) were studied using univariable and multivariable analysis. Survival rates were analyzed for both disease-free survival (DFS) and overall survival (OS) according to the presence of serious complications following surgery. There were 549 females in total. Major surgical complications occurred in 22.4% of cases. Major problems were more common among PDS patients (28.6%) compared to those who underwent early IDS (23.2%) or DDS (14.0%). Comprehensive peritonectomy and delayed surgery were found to be significant risk factors for postoperative complications in a multivariate study. Patients who experienced major complications had a median disease-free survival of 16.9 months (95% CI = [13.7-18.4]) and overall survival of 48.0 months (95% CI = [37.2-73.1]), while those who did not experience major complications had a median disease-free survival of 20.1 months (95% CI = [18.6-22.4]) and overall survival of 56.7 months (95% CI = [51.2-70.4]). Through multivariate analysis, investigators found that major surgical complications were strongly linked to DFS but not OS. The DFS of patients who had serious complications during surgery was lower than that of those who did not. Predictive predictors of postoperative morbidity included the extent of the peritonectomy and the time of the surgery.
Source: sciencedirect.com/science/article/pii/S0090825822002785
