Research output: Contribution to journal › Article › Academic › peer-review
Postoperative outcomes of primary and interval cytoreductive surgery for advanced ovarian cancer registered in the Dutch Gynecological Oncology Audit (DGOA). / On behalf of the participants of the Dutch Gynecological Oncology Collaborator Group.
In: Gynecologic oncology, Vol. 162, No. 2, 08.2021, p. 331-338.Research output: Contribution to journal › Article › Academic › peer-review
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TY - JOUR
T1 - Postoperative outcomes of primary and interval cytoreductive surgery for advanced ovarian cancer registered in the Dutch Gynecological Oncology Audit (DGOA)
AU - Baldewpersad Tewarie, N. M. S.
AU - van Driel, W. J.
AU - van Ham, M.
AU - Wouters, M. W.
AU - Kruitwagen, R.
AU - Kruse, A. J.
AU - Yigit, R.
AU - van der Aa, M.
AU - Mens, J. W.
AU - Stam, T. C.
AU - Diepstraten, J.
AU - van der Kolk, A.
AU - Verhoeve, H.
AU - Smedts, H. P. M.
AU - van Haaften-de Jong, A. M. L. D.
AU - Reesink, N.
AU - Vos, M. C.
AU - ten Cate, A. D.
AU - Slangen, B. F. M.
AU - Timmers, P. J.
AU - Smit, R. A.
AU - Gaarenstroom, K. N.
AU - Vencken, P. M. L. H.
AU - Engelen, M. J. A.
AU - Verbruggen, M. B.
AU - Boll, D.
AU - Briet, J.
AU - Fons, G.
AU - Coppus, S. F. P. J.
AU - Baalbergen, A.
AU - van Dorst, E. B. L.
AU - Tjiong, M. Y.
AU - Roes, E. M.
AU - Visschers, B. A. J. T.
AU - Gerestein, C. G.
AU - Nagel, H. T. C.
AU - Aalders, A. L.
AU - Hofman, L.
AU - Lange, J.
AU - Ebisch, I.
AU - de Waard, J.
AU - van der Plas-Koning, Y. W. C. M.
AU - On behalf of the participants of the Dutch Gynecological Oncology Collaborator Group
AU - Huisman, M.
N1 - Funding Information: None. Publisher Copyright: © 2021 The Authors Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/8
Y1 - 2021/8
N2 - Objectives: The challenge when performing cytoreductive surgery (CRS) is to balance the benefits and risks. The aim of this study was to report short term postoperative morbidity and mortality in relation to surgical outcome in patients undergoing primary debulking surgery (PDS) or interval debulking (IDS) surgery in the Netherlands. Methods: The Dutch Gynecological Oncology Audit (DGOA) was used for retrospective analysis. Patients undergoing PDS or IDS between January 1st, 2015 - December 31st, 2018 were included. Outcome was frequency of postoperative complications. Median time to adjuvant chemotherapy and severity of complications were related to outcome of CRS. Complications with Clavien-Dindo ≥3 were analyzed per region and case mix corrected. Statistical analysis was performed with R.Studio. Results: 1027 patients with PDS and 1355 patients with IDS were included. Complications with re-invention were significantly higher in PDS compared to IDS (5.7% vs. 3.6%, p = 0.048). Complete cytoreduction was 69.7% in PDS and 62.1% IDS, p < 0.001. Time to adjuvant chemotherapy was 49 days in patients with complete CRS and a complication with re-intervention. Regional variation for severe complications showed one region outside confidence intervals. Conclusions: Higher complete cytoreduction rate in the PDS group indicates that the correct patients have been selected, but is associated with a higher percentage of complication with re-intervention. As result, time to start adjuvant chemotherapy is longer in this group. Maintaining a balance in aggressiveness of surgery and outcome of the surgical procedure with respect to severe complications is underlined. Bench marked data should be discussed nationally to improve this balance.
AB - Objectives: The challenge when performing cytoreductive surgery (CRS) is to balance the benefits and risks. The aim of this study was to report short term postoperative morbidity and mortality in relation to surgical outcome in patients undergoing primary debulking surgery (PDS) or interval debulking (IDS) surgery in the Netherlands. Methods: The Dutch Gynecological Oncology Audit (DGOA) was used for retrospective analysis. Patients undergoing PDS or IDS between January 1st, 2015 - December 31st, 2018 were included. Outcome was frequency of postoperative complications. Median time to adjuvant chemotherapy and severity of complications were related to outcome of CRS. Complications with Clavien-Dindo ≥3 were analyzed per region and case mix corrected. Statistical analysis was performed with R.Studio. Results: 1027 patients with PDS and 1355 patients with IDS were included. Complications with re-invention were significantly higher in PDS compared to IDS (5.7% vs. 3.6%, p = 0.048). Complete cytoreduction was 69.7% in PDS and 62.1% IDS, p < 0.001. Time to adjuvant chemotherapy was 49 days in patients with complete CRS and a complication with re-intervention. Regional variation for severe complications showed one region outside confidence intervals. Conclusions: Higher complete cytoreduction rate in the PDS group indicates that the correct patients have been selected, but is associated with a higher percentage of complication with re-intervention. As result, time to start adjuvant chemotherapy is longer in this group. Maintaining a balance in aggressiveness of surgery and outcome of the surgical procedure with respect to severe complications is underlined. Bench marked data should be discussed nationally to improve this balance.
KW - Complications
KW - Cytroreductive surgery
KW - Postoperative outcomes
KW - Time to adjuvant chemotherapy
UR - http://www.scopus.com/inward/record.url?scp=85108605354&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2021.05.030
DO - 10.1016/j.ygyno.2021.05.030
M3 - Article
C2 - 34147284
VL - 162
SP - 331
EP - 338
JO - Gynecologic oncology
JF - Gynecologic oncology
SN - 0090-8258
IS - 2
ER -
ID: 18845578