An analysis of the influence of infection on overall survival rates, following modified posterior pelvic exenteration for advanced ovarian cancer.

Abstract

Objectives The aim of our study has been to determine the association between the appearance of infection after modified posterior pelvic exenteration (MPE) and TTC (time to adjuvant chemotherapy) and to examine whether the infection impacts clinical results by delaying the start of chemotherapy. Material and methods The present, retrospective study analyzed 77 patients who had undergone MPE followed by adjuvant chemotherapy. Either no residual tumor or tumor less than 2.5 mm was achieved in 76.7% of these patients. Patients were divided into two subgroups for comparison; the first group consisted of 41 patients with infections, the second group of 36 patients without infections. Infection after surgery was monitored within a 90-day postoperative period. Median TTC and OS (overall survival) was determined for those patients who developed infection as well as for those who did not. Results The expected 5-year survival rate was 0.40 (SD=0.09) for those patients without infection and 0.17 (SD=0.07) for those patients with infection. The survival curves of patients with infection and those without infection were statistically significantly different (p=0.038). Median TTC differed significantly for those patients who developed infection vs those patients who did not develop infection (37days vs 27.5 days, p=0.024), and patients without infection were statistically more likely to receive chemotherapy within 25 days following surgery than in the subsequent 25-42-day period compared to those patients who did develop infection (p=0.048). No statistically significant differences were found between the groups in relation to the initiation of chemotherapy within 42 days (p=0.445). Conclusions The absence of postoperative infection was associated with a better survival. Patients with infection were noted a longer time interval from surgery to start of chemotherapy without negative impact to OS.