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Showing content from https://pubmed.ncbi.nlm.nih.gov/34879081/ below:

Trends in extent of surgical cytoreduction for patients with ovarian cancer

. 2021 Dec 8;16(12):e0260255. doi: 10.1371/journal.pone.0260255. eCollection 2021. Trends in extent of surgical cytoreduction for patients with ovarian cancer

Affiliations

¹ David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America.
² Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, California, United States of America.
³ Division of Cardiac Surgery, Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America.
⁴ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Miami, Florida, United States of America.

PMID: 34879081
PMCID: PMC8654234
DOI: 10.1371/journal.pone.0260255

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Trends in extent of surgical cytoreduction for patients with ovarian cancer

Deanna H Wong et al. PLoS One. 2021.

. 2021 Dec 8;16(12):e0260255. doi: 10.1371/journal.pone.0260255. eCollection 2021. Affiliations

¹ David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America.
² Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, California, United States of America.
³ Division of Cardiac Surgery, Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America.
⁴ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Miami, Florida, United States of America.

PMID: 34879081
PMCID: PMC8654234
DOI: 10.1371/journal.pone.0260255

Item in Clipboard

Abstract

Purpose: To identify patient and hospital characteristics associated with extended surgical cytoreduction in the treatment of ovarian cancer.

Methods: A retrospective analysis using the National Inpatient Sample (NIS) database identified women hospitalized for surgery to remove an ovarian malignancy between 2013 and 2017. Extended cytoreduction (ECR) was defined as surgery involving the bowel, liver, diaphragm, bladder, stomach, or spleen. Chi-square and logistic regression were used to analyze patient and hospital demographics related to ECR, and trends were assessed using the Cochran-Armitage test.

Results: Of the estimated 79,400 patients undergoing ovarian cancer surgery, 22% received ECR. Decreased adjusted odds of ECR were found in patients with lower Elixhauser Comorbidity Index (ECI) scores (OR 0.61, p<0.001 for ECI 2, versus ECI≥3) or residence outside the top income quartile (OR 0.71, p<0.001 for Q1, versus Q4), and increased odds were seen at hospitals with high ovarian cancer surgical volume (OR 1.25, p<0.001, versus low volume). From 2013 to 2017, there was a decrease in the proportion of cases with extended procedures (19% to 15%, p<0.001). There were significant decreases in the proportion of cases with small bowel, colon, and rectosigmoid resections (p<0.001). Patients who underwent ECR were more likely treated at a high surgical volume hospital (37% vs 31%, p<0.001) over the study period. For their hospital admission, patients who underwent ECR had increased mortality (1.6% vs. 0.5%, p<0.001), length of stay (9.6 days vs. 5.2 days, p<0.001), and mean cost ($32,132 vs. $17,363, p<0.001).

Conclusions: Likelihood of ECR was associated with increased medical comorbidity complexity, higher income, and undergoing the procedure at high surgical volume hospitals. The proportion of ovarian cancer cases with ECR has decreased from 2013-17, with more cases performed at high surgical volume hospitals.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures
Fig 1. The proportion of extended procedures…

Fig 1. The proportion of extended procedures across all hospitals each year.

*Significance at P…

Fig 1. The proportion of extended procedures across all hospitals each year.

*Significance at P<0.05.

Fig 2. The proportion of all cytoreduction…

Fig 2. The proportion of all cytoreduction procedures involving the gastrointestinal tract each year.

*Significance…

Fig 2. The proportion of all cytoreduction procedures involving the gastrointestinal tract each year.

*Significance at P<0.05.

Fig 3. The proportion of extended procedures…

Fig 3. The proportion of extended procedures performed at high, medium, and low volume hospitals…
Fig 3. The proportion of extended procedures performed at high, medium, and low volume hospitals each year.

*Significance at P<0.05.