Skip to main content

Advertisement

Log in

Prognostic Significance of Postoperative Morbidities in Patients With Advanced Epithelial Ovarian Cancer Treated With Neoadjuvant Chemotherapy and Delayed Primary Surgical Debulking

  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstarct

Background

To examine the prognostic significance of postoperative morbidities in patients with ovarian cancer treated with neoadjuvant chemotherapy and interval surgical debulking.

Methods

Retrospective chart reviews of all patients treated with neoadjuvant chemotherapy and interval debulking were performed from 1999 to 2002. Descriptive statistics were used to summarize the distributions of important clinical variables. Logistic regression was used to identify statistically significant predictors of postoperative morbidities. Cox regression was used to model time to first clinical progression. Survivals were estimated by the Kaplan-Meier method and compared with the log rank test. P < .05 was considered to be statistically significant.

Results

Fifty-eight patients were treated with neoadjuvant platinum-taxane combination chemotherapy. Major surgical complications were observed in four patients (6.8%). There were no perioperative deaths. The presence of concurrent medical comorbidities was associated with the development of significant postoperative morbidities (P = .038). Cox regression showed any macroscopic residual disease (P = .04) and the presence of significant postoperative morbidities (odds ratio, 4.7, 95% confidence interval, 1.8–12.7, P = .002) to be predictive of a shorter progression-free interval.

Conclusions

Neoadjuvant chemotherapy followed by interval surgical debulking carried a low risk for postoperative morbidity. The adverse influence of marked postoperative morbidity on progression-free survival needs further study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

FIG. 1.
FIG. 2.

Similar content being viewed by others

References

  1. National Cancer Institute of Canada. Canadian Cancer Statistics 2005. Toronto: Canadian Cancer Society; National Cancer Institute of Canada; Statistics Canada; Provincial/Territorial Cancer Registries; Health Canada, 2005

  2. Omura GA, Brady MF, Homseley HD, et al. Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience. J Clin Oncol 1991; 9:1138–50

    PubMed  CAS  Google Scholar 

  3. Van Houwelingen JC, ten Bokkel Huinink WW, van der Burg ME, et al. Predictability of the survival of patients with advanced ovarian cancer. J Clin Oncol 1989; 7:769–73

    PubMed  Google Scholar 

  4. Hoskins WJ. Surgical staging and cytoreductive surgery of epithelial ovarian cancer. Cancer 1993; 71(4 Suppl):1534–40

    PubMed  CAS  Google Scholar 

  5. Van der Burg ME, van Lent M, Buyse M, et al. The effect of debulking surgery after induction. Gynecological Cancer Cooperative Group of European Organization for Research and Treatment of Cancer. N Engl J Med 1995; 332:629–34

    Article  PubMed  Google Scholar 

  6. Brown JV, Karlan BY, Greenspoon JS, et al. Periprative coagulopathy in patients undergoing primary cytoreduction. Cancer 1993; 71:2557–61

    Article  PubMed  CAS  Google Scholar 

  7. Buchsbaum HJ, Brady MF, Delgado G, et al. Surgical staging of ovarian carcinoma. Surg Gynecol Obstet 1989; 169:226–32

    PubMed  CAS  Google Scholar 

  8. Chen SS, Bochner R. Assessment of morbidity and mortality in primary cytoreductive surgery for advanced ovarian cavinoma. Gynecol Oncol 1985; 10:190–7

    Article  Google Scholar 

  9. Deppe G, Malviya VK, Malone JM Jr, et al. Debulking of pelvic and para-aortic lymph node metastases in ovarian cancer with Cavitron ultrasonic surgical aspirator. Obstet Gynecol 1990; 76:1140–2

    PubMed  CAS  Google Scholar 

  10. Eisenkop SM, Spirtos NM, Montag TW, et al. The impact of subspecialty on the management of advanced ovarian carcinoma. Gynecol Oncol 1992; 47:203–9

    Article  PubMed  CAS  Google Scholar 

  11. Guidozzi F, Ball JHS. Extensive primary cytoreductive surgery for advanced epithelial ovarian cancer. Gynecol Oncol 1994; 53:326–30

    Article  PubMed  CAS  Google Scholar 

  12. Schwarz GF, Meltzer AJ. Breast conservation after neoadjuvent chemotherapy for stage II carcinoma of the breast. Am Coll Surg 2005; 201:327–34

    Article  Google Scholar 

  13. Singletary SE. Breast cancer: the value of preoperative chemotherapy. Am J Cancer 2002; 1:121–6

    Article  Google Scholar 

  14. Lam CW, Chen WT, Liu MT, Chang CS. Effects of preoperative concurrent chemotherapy in locally advanced low rectal cancer after radical resection surgery. Int Surg 2005; 90:53–9

    PubMed  Google Scholar 

  15. Nudelman IL, Fuko V, Geller A. Treatment or rectal cancer by chemoradiation followed by surgery: analysis and early clinical outcome in 66 patients. Isr Med Assoc J 2005; 7:377–80

    PubMed  Google Scholar 

  16. De Paoli A, Innocente R, Buonadonna A. Neoadjuvant therapy of rectal cancer new treatment perspectives. Tumori 2004; 90:373–8

    PubMed  Google Scholar 

  17. Osti MF, Valeriani M, Masoni L. Neoadjuvent chemoradiation for locally advanced carcinoma of the rectum. Tumori 2004; 90:303–9

    PubMed  Google Scholar 

  18. Abbas A, Tunio MA, Ali N. Neoadjuvent chemoradiation in unresectable carcinoma of rectum. J Ayub Med Coll Abbottabad 2004; 16:24–9

    PubMed  Google Scholar 

  19. Santin AD, Bellone S, Parrish RS, et al. Influence of allogeneic blood transfusion on clinical outcome during radiotherapy for cancer of the uterine cervix. Gynecol Obstet Invest 2003; 56:28–34

    Article  PubMed  CAS  Google Scholar 

  20. Brand A. Immunological aspects of blood transfusions. Transpl Immunol 2002;10:183–90

    Article  PubMed  CAS  Google Scholar 

  21. Blumberg N, Triulzi DJ, Heal JM. Transfusion-induced immunomodulation and its clinical consequences. Transfus Med Rev 1990; 4(4 Suppl 1):24–35

    PubMed  CAS  Google Scholar 

  22. Tartter PI, Burrows L, Papatestas AE, Lesnick G, Aufses AH Jr. Perioperative blood transfusion has prognostic significance for breast cancer. Surgery 1985; 97:225–30

    PubMed  CAS  Google Scholar 

  23. Craig SR, Adam DJ, Yap PL, et al. Effect of blood transfusion on survival after esophagogastrectomy for carcinoma. Ann Thorac Surg 1998; 66:356–61

    Article  PubMed  CAS  Google Scholar 

  24. Tartter PI, Burrows L, Kirschner P. Perioperative blood transfusion adversely affects prognosis after resection of Stage I (subset N0) non–oat cell lung cancer. J Thorac Cardiovasc Surg 1984; 88(5 Pt 1):659–62

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tien Le MD, FRCSC.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Le, T., Alshaikh, G., Hopkins, L. et al. Prognostic Significance of Postoperative Morbidities in Patients With Advanced Epithelial Ovarian Cancer Treated With Neoadjuvant Chemotherapy and Delayed Primary Surgical Debulking. Ann Surg Oncol 13, 1711–1716 (2006). https://doi.org/10.1245/s10434-006-9125-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-006-9125-6

Keywords

Navigation