Abstract
<b>Objectives:</b> The objective of this study was to assess the effect of postoperative complications after SCS for patients (pts) with platinum-sensitive recurrent ovarian cancer on time to initiation of standard postoperative chemotherapy and oncologic outcomes. <b>Methods:</b> An exploratory analysis was performed on the data from a randomized phase II study assessing SCS and carboplatin hyperthermic intraperitoneal chemotherapy (HIPEC) for platinum-sensitive recurrent ovarian cancer. In the phase II study, HIPEC was not associated with a delay in postoperative chemotherapy, a difference in postoperative complications, or survival. Patient demographics, clinical characteristics, complications, time to initiation of postoperative chemotherapy, progression-free survival (PFS), and overall survival (OS) were assessed. Complications were graded by our institution's surgical secondary events (SSE) systems. Pts were categorized by SSE > grade 2 event, and pts with no postoperative complications (including pts with SSE grade 1 event). Standard statistical tests were used. <b>Results:</b> Among the 98pts undergoing SCS, 37 (38%) had any SSE grade postoperative event; 36 of these 37 pts (97%) had the event within 30 days of surgery. Of these, 22 pts had one event, 13 had two events, one had three events, and one had four events. Twenty- six pts (27%) had a >2 grade SSE. The median time to initiation of chemotherapy after SCS was 32 days (18-91 days). The most frequent complications reported were anemia (<i>n</i>=14/55, 25%) and infectious complications (<i>n</i>=21/55, 38%), including wound infection, urinary tract infection, abscess/collection, cellulitis, and pneumonia. Eight pts experienced SSE grade 3 complications postoperatively. There were no grade 4 events. No mortality was observed. Median time to initiation of chemotherapy was 32 (21-91) versus 34 (18-60) days for pts without SSE grade >2 events versus pts with SSE grade >2 events (p=0.023). Median PFS was 14.5 (95% CI: 10.7-18.3) versus 15.1 (95% CI: 12.9-17.2) months for pts without SSE grade >2 versus pts with SSE grade ≥2 events (p=0.84). Median OS was 58.5 (95% CI: 40.4-76.4) versus 60.5 (95% CI: 39.5-81.5) months for pts without SSE grade >2 versus pts with SSE grade >2 events (p=0.29). <b>Conclusions:</b> Infectious complications and anemia were the most common postoperative complications observed within 30 days of SCS. Postoperative complications in pts undergoing SCS were associated with a delay of two days in standard postoperative chemotherapy but did not impact oncologic outcomes.
Published Version
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