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Original Research

Open Access

Nomogram for 30-day morbidity after primary cytoreductive surgery for advanced stage ovarian cancer

  • G.M. Nieuwenhuyzen- de Boer1,*,
  • C.G. Gerestein1,2
  • M.J.C. Eijkemans3
  • C.W. Burger1
  • G.S. Koo4

1 Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Daniel Den Hoed/Erasmus MC University Medical Center, Rotterdam, The Netherlands

2Department of Obstetrics and Gynecology, Meander Medisch Centrum, Amersfoort, The Netherlands

3Julius Centre for Health Sciences and Primary care, University Medical Centra Utrecht, Utrecht, The Netherlands

4Department of Obstetrics and Gynecology, Albert Schweitzer Hospital, Dordrecht, The Netherlands

DOI: 10.12892/ejgo2762.2016 Vol.37,Issue 1,February 2016 pp.63-68

Published: 10 February 2016

*Corresponding Author(s): G.M. Nieuwenhuyzen- de Boer E-mail: g.nieuwenhuyzen-deboer@erasmusmc.nl

Abstract

Purpose of investigation: Extensive surgical procedures to achieve maximal cytoreduction in patients with advanced stage epithelial ovarian cancer (EOC) are inevitably associated with postoperative morbidity and mortality. This study aimed to identify preoperative predictors of 30-day morbidity after primary cytoreductive surgery for advanced stage EOC and to develop a nomogram for individual risk assessment. Materials and Methods: Patients in The Netherlands who underwent primary cytoreductive surgery for advanced stage EOC between January 2004 and December 2007. All peri- and postoperative complications within 30 days after surgery were registered and classified. To investigate predictors of 30-day morbidity, a Cox proportional hazard model with backward stepwise elimination was utilized. The identified predictors were entered into a nomogram. The main outcome was to identify parameters that predict operative risk. Results: 293 patients entered the study protocol. Optimal cytoreduction was achieved in 136 (46%) patients. Thirty-day morbidity was seen in 99 (34%) patients. Morbidity could be predicted by age (p = 0.033; OR 1.024), preoperative hemoglobin (p = 0.194; OR 0.843), and WHO performance status (p = 0.015; OR 1.821) with a optimismcorrected c-statistic of 0.62. Determinants co-morbidity status, serum CA125 level, platelet count, and presence of ascites were comparable in both groups. Conclusions: Thirty-day morbidity after primary cytoreductive surgery for advanced stage EOC could be predicted by age, hemoglobin, and WHO performance status. The generated nomogram could be valuable for predicting operative risk in the individual patient.

Keywords

Ovarian cancer; Cytoreductive surgery; 30-day morbidity; Prediction model; Operative risk.

Cite and Share

G.M. Nieuwenhuyzen- de Boer,C.G. Gerestein,M.J.C. Eijkemans,C.W. Burger,G.S. Koo. Nomogram for 30-day morbidity after primary cytoreductive surgery for advanced stage ovarian cancer. European Journal of Gynaecological Oncology. 2016. 37(1);63-68.

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