Predictive Factors for Surgical Morbidities and Adjuvant Chemotherapy Delay for Advanced Ovarian Cancer Patients Treated by Primary Debulking Surgery or Interval Debulking Surgery

Autor(es)

Ruiz Castro, Beatriz Guerreiro ^[1] ; dos Reis, Ricardo ^[2] ; Cintra, Georgia Fontes ^[2] ; de Assuncao Sousa, Mileide Maria ^[2] ; Vieira, Marcelo de Andrade ^[2] ; Mattos da Cunha Andrade, Carlos Eduardo ^{[1, 2]}

Afiliação do(s) autor(es)

^[1] Dr Paulo Prata FACISB, Barretos Sch Hlth Sci, Sao Paulo - Brazil

^[2] Barretos Canc Hosp, Gynecol Oncol Dept, Barretos, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: International Journal of Gynecological Cancer; v. 28, n. 8, p. 1520-1528, OCT 2018.
• Citações Web of Science: 1

Resumo

Objective: Postoperative complications and adjuvant chemotherapy delay (ACD) are the most damaging outcomes after surgical treatment of advanced ovarian cancer. Establishing predictive factors should prevent their occurrence. Methods: We analyzed retrospectively all patients with advanced ovarian cancer who underwent cytoreduction at our institution between December 2010 and May 2016. We evaluated all 30-day complications and considered ACD all cases who did not start adjuvant chemotherapy until 42 days or did not perform it after cytoreductive surgery. These data were analyzed in the general group, and between primary debulking surgery (PDS) and interval debulking surgery (IDS) using chi(2) test and Student t test. Relationship of variables was verified using Multiple Logistic Regression. Results: A total of 83 women were included. Of these, 43 (51.8%) were submitted to PDS and 40 (48.2%) to IDS. In the PDS group, 23 (53.5%) of the patients had complications. For the IDS group, 27 (67.5%) complicated (P = 0.192). Regarding the general group, independent predictors for 30-day complications were presence of comorbidities (odds ratio {[}OR], 5.466, 95% confidence interval {[}CI], 1.151-25,972; P = 0.033) and estimated blood loss of greater than 300 mL (OR, 14.407; 95% CI, 2.736-75.863; P = 0.002). In multivariate analysis of the general group, independent predictors for ACD were the presence of hypertension as comorbidity (OR, 3.898; 95% CI, 1.119-13.578; P = 0.033), body mass index of greater than 30 kg/m(2) (OR, 5.728; 95% CI, 1.169-28.069; P = 0.031), 30-day reoperation (OR, 21.275; 95% CI, 1.799-251.651; P = 0.015), and fever within 30 days (OR, 11.594; 95% CI, 1.714-78.412; P = 0.012). Conclusions: Comorbidities and intraoperative bleeding are the most relevant findings related to surgical complications. Surgical approach (PDS or IDS) was not related with complications. Surgical complications were significantly related to ACD. (AU)

• Processo FAPESP: 16/02443-5 - Fatores preditores de morbidade pós-operatória e de demora para início da quimioterapia adjuvante para pacientes com câncer de ovário avançado tratadas por citorredução
• Beneficiário: Beatriz Guerreiro Ruiz Castro
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica