Feasibility and operative outcomes of surgery in the liver area in advanced ovarian cancer.
Gynecol Oncol
; 187: 98-104, 2024 May 14.
Article
en En
| MEDLINE
| ID: mdl-38749171
ABSTRACT
OBJECTIVE:
The study aimed to characterize intra-and postoperative complications according to a standardized anatomo-surgical classification for ovarian cancer metastases in the liver area.METHODS:
Data from all patients with advanced ovarian cancer undergoing primary or secondary surgery with perihepatic liver involvement (May-2016 to May-2022), were retrospectively retrieved and classified according to a standardized anatomo-surgical classification, and clustered into four Classes Class I "Peritoneal", Class II "Hepatoceliac-lymph-nodes", Class III "Parenchymal" and Class IV Mixed (≥ 2 classes).RESULTS:
Data from 615 patients were collected. Intraoperative complications were observed in 15%, and severe postoperative complications in 17.6% of cases. While surgical complexity scores were similar, Class IV had longer operative times, higher blood loss, and a 30.4% intraoperative transfusion rate. Class II showed a higher prevalence of vascular injuries (8%). Classes II and IV were significantly associated with severe postoperative complications. Specific complications varied among classes, such as perihepatic collection and intrahepatic hematoma/abscess in Class III (p = 0.003, p < 0.001, respectively), and pleuric effusion, sepsis, anemia, and "other complications" in Class IV (p = 0.002, p = 0.004, p = 0.03, p = 0.03, respectively). Multivariable analysis identified Class II and IV (Class II OR 4.991, p = 0.045; Class IV OR 5.331, p = 0.030), Surgical Complexity Score group 3 (OR3.922, p = 0.003), and the presence of residual tumor (OR1.748, p = 0.048) as independent risk factors for severe postoperative complications.CONCLUSIONS:
Liver procedures during advanced ovarian cancer surgery are feasible with acceptable complication rates According to the anatomo-surgical classification, metastatic patterns are related to both different surgical outcomes and postoperative complication profiles.
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Bases de datos:
MEDLINE
Idioma:
En
Revista:
Gynecol Oncol
Año:
2024
Tipo del documento:
Article
País de afiliación:
Italia