Significance of Perioperative Infection in Survival of Patients With Ovarian Cancer

被引：39

作者：

Matsuo, Koji ^{[1
]}

Prather, Christina P. ^{[2
]}

Ahn, Edward H. ^{[3
]}

Eno, Michele L. ^{[4
]}

Tierney, Katherine E. ^{[1
]}

Yessaian, Annie A. ^{[1
]}

Im, Dwight D. ^{[5
]}

Rosenshein, Neil B. ^{[5
]}

Roman, Lynda D. ^{[1
]}

机构：

[1] Univ So Calif, Los Angeles Cty Med Ctr, Dept Obstet & Gynecol, Div Gynecol Oncol, Los Angeles, CA 90031 USA

[2] Univ N Carolina, Dept Internal Med, Chapel Hill, NC USA

[3] Beth Israel Deaconess Med Ctr, Dept Radiol, Boston, MA 02215 USA

[4] Cedars Sinai Med Ctr, Dept Obstet & Gynecol, Los Angeles, CA 90048 USA

[5] Mercy Med Ctr, Gynecol Oncol Ctr, Baltimore, MD USA

来源：

INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER | 2012年 / 22卷 / 02期

关键词：

Ovarian cancer; Perioperative infection; Surgical mortality; Survival; Prediction; INTRATUMORAL T-CELLS; CYTOREDUCTIVE SURGERY; EPITHELIAL OVARIAN; LUNG-CANCER; PLATINUM; INTERLEUKIN-1; CHEMOTHERAPY; RESISTANCE; TLR-4;

D O I：

10.1097/IGC.0b013e31823bd6db

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives: Perioperative infectious diseases comprise some of the most common causes of surgical mortality in women with ovarian cancer. This study was aimed to evaluate the significance of perioperative infections in survival of patients with ovarian cancer. Methods: Patients who underwent primary cytoreductive surgery were included in the analysis (n = 276). The enumeration and speciation of pathogens, antimicrobial agents used, and sensitivity assay results were culled from medical records and correlated to clinicopathologic demographics and survival outcomes. Perioperative infection was determined as a positive microbiology result obtained within a 6-week postoperative period. Results: The incidence of perioperative infection was 15.9% (common sites: urinary tract, 57.3%, and surgical wound, 21.4%). Commonly isolated pathogens were Enterococcus species (22.4%) and Escherichia coli (19.4%) in urinary tract infection, and Bacteroides fragilis, E. coli, and Klebsiella pneumoniae (all, 16%) in surgical wound infection. Imipenem represents one of the least resistant antimicrobial agents commonly seen in urinary tract and surgical wound infections in our institution. Perioperative infection was associated with diabetes, serous histology, lymph node metastasis, bowel resection, decreased bicarbonate, and elevated serum urea nitrogen in multivariate analysis. Perioperative infections were associated with increased surgical mortality, delay in chemotherapy treatment, decreased chemotherapy response, shorter progression-free survival (median time, 8.4 vs 17.6 months; P < 0.001), and decreased overall survival (29.0 vs 51.8 months; P = 0.011). Multivariate analysis showed that perioperative infections other than urinary tract infection remained a significant risk factor for decreased survival (progression-free survival, P = 0.02; and overall survival, P = 0.019). Conclusion: Perioperative infectious disease comprises an independent risk factor for survival of patients with ovarian cancer.

引用

页码：245 / 253

页数：9

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