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64 Predictors of postoperative morbidity after cytoreductive surgery for advanced ovarian cancer: analysis and management of complications
  1. V Di Donato,
  2. A Di Pinto,
  3. E Benedetti,
  4. I Palaia,
  5. G Perniola,
  6. M Schiavi,
  7. A Musella,
  8. F Tomao,
  9. L Muzii and
  10. P Benedetti Panici
  1. University Sapienza, Department of gynecological obstetrical and urological sciences., Rome, Italy


Objectives To evaluate a correlation between pre-surgical condition as predictor of overall, severe complications and 90 days mortality in patients undergoing cytoreductive surgery for advanced ovarian cancer.

Methods Consecutive patients affected by advanced ovarian cancer who have undergone cytoreduction surgery were considered for the study. Patients’ characteristics’ and surgical data were recorded. Modified Frailty Index (mFI) was evaluated. Higher mFI scores indicated more severe comorbidities. Postoperative complications were evaluated and graded according to Accordion score. Logistic regression was used to evaluate the associations between clinical and surgical variables and severe or overall complications.

Results 263 patients were included. 86 patients developed at least one complication: 70 (26.6%) of these reported mild complications, 13 (4.9%) developed severe complications, 3(1.1%) died within 90 days from surgery. At multivariate analysis logistic regression mFI>3 (OR: 1.67, CI 95% 1.08–2.81;p=0.05) the complexity of surgical procedures performed (OR: 4.15, CI 95% 2.38–7.23; p<0.001) were independent predictors of overall complications, while BMI>30 (OR: 5.13, CI 95%:1.15–22.92, p=0.03), mFI>3 (OR:2.45,CI95%:1.06–5.67;p=0.04),high complexity surgery executed (OR:12.31,CI95%:3.08–47.74;p<0.001) were independent predictors of severe complications.

Conclusions mFI and high complexity surgery are predictive of Severe and Overall Complications. Patients’ pre-operative care profile evaluation may guide specialists in reducing, preventing and managing complications correctly. mFI seems to be effective in identify high-risk patients and represent a valuable tool to help health professionals in providing risk counseling and discussion of management for women undergoing surgery for gynecologic cancer.

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