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

   


Authors: Tanner, E. J.; Long, K. C.; Zhou, Q.; Brightwell, R. M.; Gardner, G. J.; Abu-Rustum, N. R.; Leitao, M. M. Jr; Sonoda, Y.; Barakat, R. R.; Iasonos, A.; Chi, D. S.
Article Title: Impact of operative start time on surgical outcomes in patients undergoing primary cytoreduction for advanced ovarian cancer
Abstract: 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. © 2012 Elsevier Inc. All rights reserved.
Keywords: adult; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; young adult; major clinical study; advanced cancer; ascites; cancer patient; cancer staging; neoplasm staging; cytoreductive surgery; ovarian neoplasms; protein blood level; ovary cancer; cohort studies; cohort analysis; time factors; albumin; minimal residual disease; operation duration; surgeon; multivariate logistic regression analysis; gynecologic surgical procedures; ca 125 antigen; cystadenocarcinoma, serous; advanced ovarian cancer; logistic regression analysis; carcinomatosis; abdominal disease; operative start time
Journal Title: Gynecologic Oncology
Volume: 126
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2012-07-01
Start Page: 58
End Page: 63
Language: English
DOI: 10.1016/j.ygyno.2012.04.014
PROVIDER: scopus
PUBMED: 22507533
PMCID: PMC4831057
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-84862769565&partnerID=40&md5=ac677f0e082507a9748efe5200e34227
Notes: --- - "Export Date: 1 August 2012" - "CODEN: GYNOA" - "Source: Scopus"
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MSK Authors
  1. Ginger J Gardner
    270 Gardner
  2. Richard R Barakat
    629 Barakat
  3. Dennis S Chi
    707 Chi
  4. Yukio Sonoda
    472 Sonoda
  5. Mario Leitao
    575 Leitao
  6. Nadeem Abu-Rustum
    888 Abu-Rustum
  7. Qin Zhou
    253 Zhou
  8. Alexia Elia Iasonos
    362 Iasonos
  9. Edward James Tanner
    40 Tanner
  10. Kara Long Roche
    247 Long Roche
  11. Rachel Michele Brightwell
    3 Brightwell
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