Article ID Journal Published Year Pages File Type
3945382 Gynecologic Oncology 2016 6 Pages PDF
Abstract

•Prediction of postoperative complications may be helpful to individualized the primary treatment in AEOC women.•AEOC patients with high risk for postoperative complications could be identified preoperatively.•This study develops a laparoscopic adjusted score to predict post-operative complications in AEOC patients undergoing PDS.

ObjectiveTo develop and validate a simple adjusted laparoscopic score to predict major postoperative complications after primary debulking surgery (PDS) in advanced epithelial ovarian cancer (AEOC).MethodsFrom January 2006 to June 2015, preoperative, intraoperative, and post-operative outcome data from patients undergoing staging laparoscopy (S-LPS) before receiving PDS (n = 555) were prospectively collected in an electronic database and retrospectively analyzed. Major complications were defined as levels 3 to 5 of MSKCC classification. On the basis of a multivariate regression model, the score was developed using a random two-thirds of the population (n = 370) and was validated on the remaining one-third patients (n = 185).ResultsMajor complication rate was 18.3% (102/555). Significant predictors included in the scoring system were: poor performance status, presence of ascites (> 500 cm3), CA125 serum level (> 1000 U/ml), and high laparoscopic tumor load (predictive index value, PIV ≥ 8). The mean risk of developing major postoperative complications was 3.7% in patients with score 0 to 2, 13.2% in patients with score 3 to 5, 37.1% in patients with score 6 to 8. In the validation population, the predicted risk of major complications was 17.8% (33/185) versus a 16.7% (31/185) observed risk (C-statistic index = 0.790).ConclusionThis new score may accurately predict a patient's postoperative outcome. Early identification of high-risk patients could help the surgeon to adopt tailored strategies on individual basis.

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