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Association Between Preoperative Chemotherapy and Postoperative Complications in Patients Undergoing Surgery for Ovarian Cancer

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

Abstract

Background

This study sought to determine the association between preoperative chemotherapy and postoperative morbidity and mortality in ovarian cancer patients.

Methods

The American College of Surgeons National Surgical Quality Improvement Program was used to identify women who underwent surgery for ovarian cancer between 2005 and 2012. The women were divided into two groups based on whether they had received chemotherapy within 30 days before surgery or not. Preoperative variables, intraoperative measures, and postoperative morbidity and mortality were compared using χ 2 and Student’s t test. Multivariable analyses using logistic regression modeling were used to correct for potential confounding variables.

Results

Of 1807 patients, 1612 (89.2 %) underwent primary surgery, and 195 (10.8 %) received preoperative chemotherapy. The chemotherapy group had a lower preoperative platelet count (317,640 vs 249,740 plt/μL; P < 0.001), hematocrit (36.9 vs 33.1 %; P < 0.001), and white blood cell (WBC) count (7970 vs 6060 WBC/μL; P < 0.001). Postoperatively, the chemotherapy group had a higher rate of organ/space infection (2.2 vs 4.6 %; P = 0.04; odds ratio [OR], 2.12; 95 % confidence interval [CI], 1.01–4.47) and a higher blood transfusion rate (17.1 vs 32.3 %; P < 0.001; OR, 2.31; 95 % CI, 1.67–3.20). A subanalysis of only those with disseminated cancer showed myelosuppression and an increased blood transfusion rate in the chemotherapy group. In multivariable analyses, preoperative chemotherapy, hematocrit, and ascites were independent predictors of postoperative blood transfusion in the entire cohort, whereas preoperative chemotherapy was the only independent predictor of postoperative blood transfusion in the disseminated cancer group.

Conclusions

Preoperative chemotherapy for the treatment of ovarian cancer is associated with myelosuppression and an increased risk of postoperative blood transfusion.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA

    David W. Doo MD & Jeanelle Sheeder PhD

  2. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA

    Michael S. Guy MD, Kian Behbakht MD, Susan A. Davidson MD & Saketh R. Guntupalli MD

Authors
  1. David W. Doo MD
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  2. Michael S. Guy MD
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  3. Kian Behbakht MD
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  4. Susan A. Davidson MD
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  5. Jeanelle Sheeder PhD
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  6. Saketh R. Guntupalli MD
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Correspondence to David W. Doo MD.

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Doo, D.W., Guy, M.S., Behbakht, K. et al. Association Between Preoperative Chemotherapy and Postoperative Complications in Patients Undergoing Surgery for Ovarian Cancer. Ann Surg Oncol 23, 968–974 (2016). https://doi.org/10.1245/s10434-015-4955-8

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  • DOI: https://doi.org/10.1245/s10434-015-4955-8

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