Impact of operative start time on surgical outcomes in patients undergoing primary cytoreduction for advanced ovarian cancer

被引：20

作者：

Tanner, Edward J. ^{[1
]}

Long, Kara C. ^{[1
]}

Zhou, Qin ^{[2
]}

Brightwell, Rachel M. ^{[1
]}

Gardner, Ginger J. ^{[1
]}

Abu-Rustum, Nadeem R. ^{[1
]}

Leitao, Mario M., Jr. ^{[1
]}

Sonoda, Yukio ^{[1
]}

Barakat, Richard R. ^{[1
]}

Iasonos, Alexia ^{[2
]}

Chi, Dennis S. ^{[1
]}

机构：

[1] Mem Sloan Kettering Canc Ctr, Dept Surg, Gynecol Serv, New York, NY 10065 USA

[2] Mem Sloan Kettering Canc Ctr, Dept Biostat, New York, NY 10065 USA

来源：

GYNECOLOGIC ONCOLOGY | 2012年 / 126卷 / 01期

关键词：

Cytoreductive surgery; Advanced ovarian cancer; Operative start time; QUALITY-IMPROVEMENT; SLEEP-DEPRIVATION; SURGERY; SURVIVAL; MORBIDITY; PERFORMANCE; CARCINOMA; DISEASE; PART;

D O I：

10.1016/j.ygyno.2012.04.014

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives. To evaluate the impact of operative start time (OST) on surgical outcomes in patients with advanced ovarian cancer. Methods. All stage IIIB-IV serous ovarian cancer patients who underwent primary surgery at our institution from 1/01 to 1/10 were identified. Fourteen factors were evaluated for an association with surgical outcomes including OST and OR tumor index (1 point each for carcinomatosis and/or bulky [>= 1 cm] upper abdominal disease). Univariate logistic regression considering within-surgeon clustering was performed for cytoreduction to <= 1 cm versus > 1 cm residual disease. In patients with <= 1 cm residual disease, univariate logistic regression considering within-surgeon clustering was performed for 1-10 mm residual disease versus complete gross resection (CGR, 0 mm residual). A multivariate logistic model was developed based on univariate analysis results in the <= 1 cm residual disease cohort. Results. Of 422 patients, residual disease was: 0 mm, 144 (34.1%); 1-10 mm, 175 (41.5%); > 10 mm, 103 (23.3%). OST was not associated with cytoreduction to <= 1 cm residual disease on univariate analysis. In the <= 1 cm residual disease cohort, albumin, CA-125, ascites, ASA score, stage, OR tumor index, and OST were associated with CGR on univariate analysis. Earlier OSTs were associated with increased rates of CGR. On multivariate analysis, CA-125 was independently associated with CGR. OST was associated with CGR in patients with an OR tumor index of 2 but not an OR tumor index < 2. Conclusions. OST was not associated with cytoreduction to <= 1 cm residual disease in patients with advanced serous ovarian cancer. In the cohort of patients with <= 1 cm residual disease, later OSTs were associated with reduced rates of CGR in patients with greater tumor burden. (c) 2012 Elsevier Inc. All rights reserved.

引用

页码：58 / 63

页数：6