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Patient-Reported Outcomes After Extensive (Ultraradical) Surgery for Ovarian Cancer: Results From a Prospective Longitudinal Feasibility Study
  1. San Soo Hoo, MBChB, MRCOG, MD,
  2. Natalie Marriott, MSc,
  3. Aimee Houlton, BSc, MSc,
  4. James Nevin, MBBCh, MRCOG, FROG,
  5. Janos Balega, MD, MRCOG,
  6. Kavita Singh, MBBS, MD, FRCOG,
  7. Jason Yap, MBBS, BSc (Hons), MRCOG,
  8. Ramya Sethuram, MBBS, MRCOG,
  9. Ahmed Elattar, MD, MRCOG,
  10. David Luesley, MD, MA, FRCOG,
  11. Sean Kehoe, MD, MA, DCH, MRCOG and
  12. Sudha Sundar, MPhil, MRCOG
  1. Pan Birmingham Gynaecological Cancer Centre, City Hospital, West Midlands, Birmingham, United Kingdom.
  1. Address correspondence and reprint requests to Sudha Sundar, MPhil, MRCOG, Pan Birmingham Gynaecological Cancer Centre, City Hospital, West Midlands, Birmingham, B18 7QH, United Kingdom. E-mail: s.s.sundar{at}


Background Extensive (ultraradical) surgery may facilitate complete cytoreduction in ovarian cancer with potential survival benefit but with greater morbidity. Currently, patient-reported outcomes (PROs) from such surgery are unknown. We conducted the Surgery in Ovarian Cancer Quality of life Evaluation Research study (SOCQER 1), a prospective study investigating the feasibility of collection of serial PROs in patients who had extensive surgery and standard surgery for ovarian cancer.

Methods Ninety-three patients were recruited for 33 months to complete serial PRO assessments using the validated EORTC QLQ-C30 and the ovarian cancer–specific QLQ-OV28 questionnaires preoperatively, at 6 weeks, and at 3, 6, and 9 months postoperatively. Aletti Surgical Complexity Score of 3 or lower was considered standard surgery; a Surgical Complexity Score of 4 or higher was considered extensive surgery. Prospective data collection was obtained from the hospital electronic database, including patient demographics, American Society of Anaesthesiologists grade, preoperative serum CA125 and albumin levels, chemotherapy regimen, and surgical morbidity.

Results Three cohorts of patients—32 benign, 32 undergoing standard surgery, and 24 undergoing extensive surgery—completed the questionnaires. Median questionnaire completion rate in this study was 64%, demonstrating the feasibility of longitudinal quality of life (QoL) assessment after surgery. Patient-reported outcomes revealed a falling trend in QoL in the short-term (6 weeks-3 months) after surgery, which gradually returned to baseline at 6 to 9 months; this trend was more marked after extensive surgery.

Conclusions This study provides useful insight into the impact of extensive surgery on patients. Further multicenter studies are needed to evaluate the impact of extensive surgery on patient’s QoL and survival.

  • Quality of life
  • Patient-reported outcomes
  • Ultraradical surgery
  • Ovarian cancer
  • Supraradical surgery

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  • The authors declare no conflicts of interest.

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