Article Text

Download PDFPDF

EPV210/#490 Prognostic implications of hemodynamic instability during ovarian cancer surgery
  1. J Kim1,
  2. SI Kim1,
  3. A Seol1,
  4. HS Kim1,
  5. HH Chung1,
  6. J-W Kim1,
  7. NH Park1,
  8. Y-S Song1 and
  9. M Lee1,2
  1. 1Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Seoul, Korea, Republic of
  2. 2Seoul National University Hospital, Department of Obstetrics and Gynecology, Seoul, Korea, Republic of


Objectives To evaluate the impact of intraoperative hypotension and hemodynamic instability on survival outcomes in patients with high-grade serous ovarian carcinoma (HGSOC).

Methods We retrospectively identified patients with HGSOC, who underwent primary or interval debulking surgery between August 2013 and December 2019. We collected anesthesia-related variables, including the arterial blood pressure measurements (at 1-min interval) during surgery of patients. The cumulative duration of mean arterial blood pressure (MAP) readings under 65 mmHg and two performance measurements (median performance error [MDPE] and wobble) were calculated. We investigated associations between the factors indicating hemodynamic instability and prognosis.

Results In total, 338 patients were included. Based on the cumulative duration of MAP under 65 mmHg, we divided patients into two groups: ≥30 min and <30 min. The progression-free survival (PFS) was worse in the ≥30 min group (n=107) than the <30 min group (n=231) (median, 18.2 vs. 23.7 months; P=0.014). In multivariate analysis adjusting for confounders, a duration of ≥30 min of MAP under 65 mmHg was identified as an independent poor prognostic factor for PFS (adjusted HR, 1.376; 95% CI, 1.035–1.830; P=0.028). Shorter PFS was observed in the group with a MDPE <4.0% (adjusted HR, 1.351; 95% CI, 1.024–1.783; P=0.033) and a wobble ≥7.5% (adjusted HR, 1.445; 95% CI, 1.100–1.899; P=0.008). However, no differences were observed in overall survival.

Conclusions The three intraoperative variables for hemodynamic instability, cumulative duration of MAP <65 mmHg, MDPE, and wobble, might be novel prognostic biomarkers for disease recurrence in patients with HGSOC.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.