6533b7d4fe1ef96bd1261e93

RESEARCH PRODUCT

A laparoscopic risk-adjusted model to predict major complications after primary debulking surgery in ovarian cancer: A single-institution assessment

Giovanni ScambiaS Gueli AllettiAnna FagottiAnna FagottiBarbara CostantiniFrancesco FanfaniI. PitruzzellaI. PitruzzellaCamilla NeroGiuseppe VizzielliValerio GallottaLucia TortorellaFrancesco Cosentino

subject

Adultmedicine.medical_specialtyPost-operative complicationsPopulationLaparoscopy; Ovarian cancer; Post-operative complications; Predictive model; Obstetrics and Gynecology; OncologyRisk AssessmentYoung Adult03 medical and health sciencesGynecologic Surgical ProceduresPostoperative Complications0302 clinical medicineOvarian cancerAscitesHumansMedicineMajor complicationLaparoscopy; Ovarian cancer; Post-operative complications; Predictive modelYoung adultLaparoscopyeducationAgedAged 80 and overOvarian Neoplasmseducation.field_of_studyModels Statistical030219 obstetrics & reproductive medicinemedicine.diagnostic_testbusiness.industryReproducibility of ResultsObstetrics and GynecologyMiddle Agedmedicine.diseaseDebulkingSurgerySettore MED/40 - GINECOLOGIA E OSTETRICIAItalyOncologyPredictive model030220 oncology & carcinogenesisFemaleLaparoscopymedicine.symptombusinessOvarian cancerRisk assessment

description

Abstract Objective To develop and validate a simple adjusted laparoscopic score to predict major postoperative complications after primary debulking surgery (PDS) in advanced epithelial ovarian cancer (AEOC). Methods From January 2006 to June 2015, preoperative, intraoperative, and post-operative outcome data from patients undergoing staging laparoscopy (S-LPS) before receiving PDS (n=555) were prospectively collected in an electronic database and retrospectively analyzed. Major complications were defined as levels 3 to 5 of MSKCC classification. On the basis of a multivariate regression model, the score was developed using a random two-thirds of the population (n=370) and was validated on the remaining one-third patients (n=185). Results Major complication rate was 18.3% (102/555). Significant predictors included in the scoring system were: poor performance status, presence of ascites (>500cm 3 ), CA125 serum level (>1000U/ml), and high laparoscopic tumor load (predictive index value, PIV ≥8). The mean risk of developing major postoperative complications was 3.7% in patients with score 0 to 2, 13.2% in patients with score 3 to 5, 37.1% in patients with score 6 to 8. In the validation population, the predicted risk of major complications was 17.8% (33/185) versus a 16.7% (31/185) observed risk (C-statistic index=0.790). Conclusion This new score may accurately predict a patient's postoperative outcome. Early identification of high-risk patients could help the surgeon to adopt tailored strategies on individual basis.

yearjournalcountryeditionlanguage
2016-01-01
10.1016/j.ygyno.2016.04.020https://hdl.handle.net/11390/1242345