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The role of factor XIII in surgery for advanced stage of epithelial ovarian cancer

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

Hereditary factor (F) XIII-deficiency is a known risk factor for postoperative complications, but data of acquired FXIII-deficiency in malignancies are limited. Therefore, we evaluated the role of acquired FXIII-deficiency in surgery for advanced epithelial ovarian cancer (EOC).

Materials and methods

We performed a retrospective analysis of patients with known serum FXIII status and treatment between 2011 and 2018 at our center. We defined cohorts according to FXIII with values > 75% as normal (group A), 55–75% as reduced (group B) and < 55% as low (group C). Complications were classified according to the Clavien–Dindo Classification, class III–V complications were defined as severe.

Results

347 patients with EOC were identified. 180 patients (51.2%) were in group A, 82 patients (23.6%) in group B, and 85 patients (24.4%) in group C. Lower levels of FXIII were associated with higher amount of ascites, FIGO IV, high grade serous histology, low albumin, and higher CA-125 levels. Regarding intraoperative variables, low FXIII was associated with longer duration of surgery, higher blood loss, higher surgical complexity score/number of bowel anastomosis and a higher probability for macroscopic residual disease. The risk of severe complications in group A was 12.2%, 24.4% in group B, and 31.8% in group C. In a multivariate model, low FXIII (OR 2.8), > 1 bowel anastomosis (OR 2.7), age-adjusted Charlson comorbidity index ≥ 4 (OR 3.6) and a longer duration of surgery (> 285 min.) were significant predictive factors for severe complications.

Conclusion

FXIII is associated with tumor and treatment burden. A low level of FXIII is associated with postoperative complications. The knowledge about the presurgical serum FXIII-level might be helpful to plan the treatment strategy.

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Authors and Affiliations

  1. Department of Gynecology and Gynecologic Oncology, Ev. Kliniken Essen-Mitte, 45136, Essen, Germany

    Mahtab Yazdian, Beyhan Ataseven, Stephanie Schneider, Thais Baert, Mareike Bommert, Alexander Traut, Richard Schwameis, Andreas du Bois & Philipp Harter

  2. Department of Gynecology and Obstetrics, Philipps-University, Marburg, Germany

    Mahtab Yazdian, Uwe Wagner & Philipp Harter

  3. Department of Anesthesiology, Ev. Kliniken-Essen-Mitte, Essen, Germany

    Harald Groeben, Alexandra Elfers-Wassenhoven & Ulrich Brüß

  4. Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany

    Beyhan Ataseven

Authors
  1. Mahtab Yazdian
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  2. Harald Groeben
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  4. Stephanie Schneider
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Contributions

MY: Conceptualization, Investigation, Supervision, original draft; Writing—review and editing. HG: Conceptualization, Investigation, Writing—review and editing. BA: Investigation, Writing—review and editing. SS: Investigation, Writing—review and editing. TB: Investigation, Writing—review and editing. MB: Investigation, Writing—review and editing. AT: Statistical analysis, Writing—review and editing. AE-W: Investigation, Writing—review and editing. UB: Investigation, Writing—review and editing. RS: Investigation, Writing—review and editing. AdB: Investigation, Writing—review and editing. UW: Investigation, Writing—review and editing. PH: Conceptualization, Investigation, Supervision, original draft; Writing—review and editing.

Corresponding author

Correspondence to Philipp Harter.

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Conflict of interest

The authors declare that there is no conflict of interest regarding the submitted work. Dr. Ataseven reports personal fees and non-financial support from Roche, personal fees from Amgen, personal fees from Astra Zeneca, personal fees and non-financial support from Tesaro/GSK, personal fees from Clovis, personal fees from Celgene, non-financial support from PharmaMar, outside the submitted work. Prof. du Bois reports personal fees and non-financial support from Roche, Astra Zeneca, Tesaro/GSK, Clovis, BIOCAD, non-financial support from Pfizer, Genmab/Seattle Genetics and MSD, outside the submitted work. Dr. Harter reports grants and personal fees from Astra Zeneca, grants and personal fees from Roche, personal fees from Sotio, grants and personal fees from Tesaro, personal fees from Stryker, personal fees from Zai Lab, personal fees from MSD, grants and personal fees from Public funding (ASCO, DKH, DFG), personal fees from Clovis, personal fees from Immunogen, grants and personal fees from GSK, grants from Boehringer Ingelheim, grants from Medac, grants from Genmab, outside the submitted work.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Yazdian, M., Groeben, H., Ataseven, B. et al. The role of factor XIII in surgery for advanced stage of epithelial ovarian cancer. Arch Gynecol Obstet 305, 1311–1318 (2022). https://doi.org/10.1007/s00404-021-06308-z

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  • DOI: https://doi.org/10.1007/s00404-021-06308-z

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