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Predictive Factors for Surgical Morbidities and Adjuvant Chemotherapy Delay for Advanced Ovarian Cancer Patients Treated by Primary Debulking Surgery or Interval Debulking Surgery
  1. Beatriz Guerreiro Ruiz Castro, MD*,
  2. Ricardo dos Reis, PhD,
  3. Geórgia Fontes Cintra, MD,
  4. Mileide Maria de Assunção Sousa, MD,
  5. Marcelo de Andrade Vieira, MD and
  6. Carlos Eduardo Mattos da Cunha Andrade, MD*,
  1. *Barretos School of Health Sciences, Dr Paulo Prata—FACISB; and
  2. Gynecologic Oncology Department, Barretos Cancer Hospital, Barretos, SP, Brazil.
  1. Address correspondence and reprint requests to Beatriz Castro MD, Gynecologic Oncology Departament, Hospital de Cancer de Barretos (Hospital de amor), Antenor Duarte Villela St, 1331, Barretos, SP 14.784-400, Brazil. E-mail: biagrcastro{at}


Objective Postoperative complications and adjuvant chemotherapy delay (ACD) are the most damaging outcomes after surgical treatment of advanced ovarian cancer. Establishing predictive factors should prevent their occurrence.

Methods We analyzed retrospectively all patients with advanced ovarian cancer who underwent cytoreduction at our institution between December 2010 and May 2016. We evaluated all 30-day complications and considered ACD all cases who did not start adjuvant chemotherapy until 42 days or did not perform it after cytoreductive surgery. These data were analyzed in the general group, and between primary debulking surgery (PDS) and interval debulking surgery (IDS) using χ2 test and Student t test. Relationship of variables was verified using Multiple Logistic Regression.

Results A total of 83 women were included. Of these, 43 (51.8%) were submitted to PDS and 40 (48.2%) to IDS. In the PDS group, 23 (53.5%) of the patients had complications. For the IDS group, 27 (67.5%) complicated (P = 0.192). Regarding the general group, independent predictors for 30-day complications were presence of comorbidities (odds ratio [OR], 5.466, 95% confidence interval [CI], 1.151–25,972; P = 0.033) and estimated blood loss of greater than 300 mL (OR, 14.407; 95% CI, 2.736–75.863; P = 0.002). In multivariate analysis of the general group, independent predictors for ACD were the presence of hypertension as comorbidity (OR, 3.898; 95% CI, 1.119–13.578; P = 0.033), body mass index of greater than 30 kg/m2 (OR, 5.728; 95% CI, 1.169-28.069; P = 0.031), 30-day reoperation (OR, 21.275; 95% CI, 1.799-251.651; P = 0.015), and fever within 30 days (OR, 11.594; 95% CI, 1.714–78.412; P = 0.012).

Conclusions Comorbidities and intraoperative bleeding are the most relevant findings related to surgical complications. Surgical approach (PDS or IDS) was not related with complications. Surgical complications were significantly related to ACD.

  • Ovarian cancer
  • Surgical morbidity
  • Chemotherapy delay
  • Complication
  • Debulking

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  • Disclosure of funding: The authors acknowledge the financial support of the Foundation for Research Support of the State of Sao Paulo (FAPESP) to this research (No. 2016/02443-5).

  • The authors declare no conflicts of interest.

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