Introduction/Background Surgeries in advanced ovarian cancer are associated with complications, including the risk of severe thromboembolic events, both due to the cancer diagnosis and the gold standard complex surgery.

Methodology All women diagnosed with ovarian, fallopian tube, or primary peritoneal cancer in FIGO stage III-IV treated with primary or interval debulking surgery between 2013 and 2017 were included in a population-based study. The women were identified using the Swedish Quality Registry for Gynecologic Cancer and data retrieved. Patient and tumor characteristics, surgical outcomes, including surgical complexity score and postoperative complications within 30 days graded according to the Clavien-Dindo (CD) classification system, were registered. Medical records were reviewed for completeness of all thromboembolic events.

All women were treated with thrombosis prophylaxis with low-molecular-weight heparin starting the day before surgery and continuing for four weeks. Women treated with complex surgery also had intermittent pneumatic compression devices during the surgeries and until fully mobilized. The number of thromboembolic events were calculated and analyzed.

Results The cohort included 384 women, where 304 (79%) were treated with primary surgery and 80 (21%) women with interval debulking surgery. Upper abdomen surgeries were performed in 121 (13.5%) women and 204 (53.1%) had intermediate or high surgical complexity scores. Complications CD I-V were registered in 112 (29%) women, whereas CD≥III in 42 (11%). There was one death within 30 days. Seven women (1.8%) were diagnosed with pulmonary embolism (CD II) and six of those also had other more severe complications. Two women (0.5%) were diagnosed with deep vein thrombosis. In total, 9 women (2.3%) had a thromboembolic event within 30 days postoperatively.

Conclusion Advanced ovarian cancer surgery is associated with complications but the rate of thromboembolic events can be considered low with active management with thrombosis prophylaxis.

Disclosures The authors declare no conflicts of interest.