The time interval from surgery to start of chemotherapy significantly impacts prognosis in patients with advanced serous ovarian carcinoma — Analysis of patient data in the prospective OVCAD study

Hofstetter, Gerda; Concin, Nicole; Braicu, Elena Ioana; Chekerov, Radoslav; Sehouli, Jalid; Cadron, Isabelle; Gorp, Toon Van; Trillsch, Fabian; Mahner, Sven; Ulmer, Hanno; Grimm, Christoph; Castillo‐Tong, Dan Cacsire; Zeillinger, Robert; Zeimet, Alain G.; Vergote, Ignace

doi:10.1016/j.ygyno.2013.07.086

Cited by 113 publications

(92 citation statements)

References 17 publications

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“…The postoperative morbidity adversely affects gynecologic cancer patients for several reasons, including escalating the costs of health care and increasing stress on a patient and their family [6]. Furthermore, if adjuvant treatment is required, timely installation of chemotherapy or radiotherapy is delayed, which is associated with impaired overall survival [22]. Thus, a preoperative prediction to identify patients at potential risk of postoperative morbidity is critical.…”

Section: Discussionmentioning

confidence: 99%

Prediction model for 30-day morbidity after gynecological malignancy surgery

Shim¹,

Dong²,

Suh³

et al. 2017

PLoS ONE

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ObjectiveThe potential risk of postoperative morbidity is important for gynecologic cancer patients because it leads to delays in adjunctive therapy and additional costs. We aimed to develop a preoperative nomogram to predict 30-day morbidity after gynecological cancer surgery.MethodsBetween 2005 and 2015, 533 consecutive patients with elective gynecological cancer surgery in our center were reviewed. Of those patients, 373 and 160 patients were assigned to the model development or validation cohort, respectively. To investigate independent predictors of 30-day morbidity, a multivariate Cox regression model with backward stepwise elimination was utilized. A nomogram based on this Cox model was developed and externally validated. Its performance was assessed using the concordance index and a calibration curve.ResultsNinety-seven (18.2%) patients had at least one postoperative complication within 30 days after surgery. After bootstrap resampling, the final model indicated age, operating time, and serum albumin level as statistically significant predictors of postoperative morbidity. The bootstrap-corrected concordance index of the nomogram incorporating these three predictors was 0.656 (95% CI, 0.608–0.723). In the validation cohort, the nomogram showed fair discrimination [concordance index: 0.674 (95% CI = 0.619–0.732] and good calibration (P = 0.614; Hosmer-Lemeshow test).ConclusionThe 30-day morbidity after gynecologic cancer surgery could be predicted according to age, operation time, and serum albumin level. After further validation using an independent dataset, the constructed nomogram could be valuable for predicting operative risk in individual patients.

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Section: Discussionmentioning

confidence: 99%

Prediction model for 30-day morbidity after gynecological malignancy surgery

Shim¹,

Dong²,

Suh³

et al. 2017

PLoS ONE

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“…SSI in ovarian cancer has previously been shown to be associated with increased postoperative mortality, increased risk of readmission, and longer TTC [8,9,19]. Additionally, delay of chemotherapy initiation following PS has been linked to decreased DFS and OS [20,21]. SSI following gynecologic cancer surgery is also associated with increased costs of care and SSIs in the setting of hysterectomy or bowel resection are reported to the Centers for Medicare and Medicaid Services (CMS) as a benchmark of institutional surgical quality [12,22].…”

Section: Discussionmentioning

confidence: 99%

Surgical site infection after primary surgery for epithelial ovarian cancer: Predictors and impact on survival

Tran

McGree

Weaver

et al. 2015

Gynecologic Oncology

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“…Early start of adjuvant treatments showed potential for improvement of survival outcomes in breast cancer [21], colon cancer [22] and ovarian cancer [23]. On the other hand, there have been no related literatures in cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Long-term results of early adjuvant concurrent chemoradiotherapy for high-risk, early stage uterine cervical cancer patients after radical hysterectomy

et al. 2017

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BackgroundThe aim of the present study was to investigate the long-term survival outcomes and toxicities associated with our experienced early administration of adjuvant concurrent chemoradiotherapy (CCRT).MethodsNinety-eight patients with pelvic lymph node metastasis, positive resection margin, and/or parametrial invasion who received adjuvant CCRT between 1995 and 2011 were analyzed retrospectively. The first cycle of platinum-based adjuvant chemotherapy was initiated within 2–3 weeks after surgery (median, 12 days) and continued every 4 weeks for a total of 4 cycles. Adjuvant radiotherapy was performed during the second and third cycles of chemotherapy.ResultsAfter a median follow-up period of 119 months for survivors, 13 patients (13.3%) experienced recurrence and 11 patients died of cancer during the follow-up period. The 5-year recurrence-free survival and cancer specific survival rates were 87.6% and 90.6%, respectively. Ninety-four patients (95.9%) received ≥3 cycles of chemotherapy. Total radiation dose of ≥45 Gy was delivered in 91 patients (92.9%). Grade 3–4 hematologic and gastrointestinal toxicities developed in 37 (37.8%) and 14 (14.3%) patients during CCRT, respectively.ConclusionThe present study confirmed the long-term safety and encouraging survival outcomes of early administration of adjuvant CCRT, suggesting the benefits of early time to initiation of adjuvant treatments.

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The time interval from surgery to start of chemotherapy significantly impacts prognosis in patients with advanced serous ovarian carcinoma — Analysis of patient data in the prospective OVCAD study

Cited by 113 publications

References 17 publications

Prediction model for 30-day morbidity after gynecological malignancy surgery

Prediction model for 30-day morbidity after gynecological malignancy surgery

Surgical site infection after primary surgery for epithelial ovarian cancer: Predictors and impact on survival

Long-term results of early adjuvant concurrent chemoradiotherapy for high-risk, early stage uterine cervical cancer patients after radical hysterectomy

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