Relationship among surgical complexity, short-term morbidity, and overall survival in primary surgery for advanced ovarian cancer
Relationship among surgical complexity, short-term morbidity, and overall survival in primary surgery for advanced ovarian cancer
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DOI：
10.1016/j.ajog.2007.10.495
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发表时间：
2007-12-01
影响因子：
9.8
通讯作者：
Cliby, William A.
中科院分区：
文献类型：
--
作者：
Aletti, Giovanni D.;Dowdy, Sean C.;Cliby, William A.
背景：晚期卵巢癌（OC）与许多患者的功能状态受损和合并症有关。这些因素都会影响到是否要进行大规模的手术细胞减少。然而，短期发病率和总生存率之间的权衡是复杂的，很少有数据分析这些变量的综合影响。目的：本研究的目的是评估患者年龄、美国麻醉医师学会（ASA）和手术复杂性评分（SCS）对短期发病率和总生存率的影响。研究设计：对一组连续的原发性卵巢癌患者进行术前患者特征、手术过程和预后评估。从1到3的SCS被开发用于调整手术的程度（分别从简单到复杂）。主要结局是30天主要发病率（败血症、血栓栓塞、心脏或再手术）、3个月死亡率和总生存期（OS）。结果：纳入了连续219例IIIC-IV期OC患者。我们观察到ASA与短期发病率（P = 0.006）和3个月死亡率（P = 0.006）之间存在相关性。年龄与短期发病率（P = 0.010）和3个月死亡率（P = 0.005）独立相关。SCS与发病率直接相关(P
BACKGROUND: Advanced ovarian cancer (OC) is associated with impaired performance status and comorbidities for many patients. These factors have an impact on the decision to perform extended surgical cytoreduction. However, the trade-off between short-term morbidity and overall survival is complex, and few data are available analyzing the combined effects of these variables.PURPOSE: The purpose of the study was to evaluate the impact of patients' age and American Society of Anesthesiologists (ASA) and surgical complexity score (SCS) on short-term morbidity and overall survival.STUDY DESIGN: Presurgical patient characteristics, surgical procedures performed, and outcomes were assessed in a cohort of consecutive primary OC patients. An SCS from 1 to 3 was developed to adjust for the extent of surgery (simple to complex, respectively). Primary outcomes were 30 day major morbidity (sepsis, thromboembolic, cardiac, or reoperation), 3 month mortality, and overall survival (OS).RESULTS: Two hundred nineteen consecutive patients with stage IIIC-IV OC were included. We observed a correlation between ASA and both short-term morbidity (P = .006) and 3 month mortality (P = .006). Age was independently associated with both short-term morbidity (P = .010) and 3 month mortality (P = .005). SCS correlated directly with morbidity (P