Objective:The goal of this study was to find the risk factors for major intraoperative blood loss(MBL)of pr imary debulking surgery(PDS)for ovarian cancer.Methods:Patients wi th ovarian cancer who underwent PDS in our...Objective:The goal of this study was to find the risk factors for major intraoperative blood loss(MBL)of pr imary debulking surgery(PDS)for ovarian cancer.Methods:Patients wi th ovarian cancer who underwent PDS in our hospital,from 2010 to 2017,were enrolled.The association between risk factors and MBL was modeled with the use of logisde regr ession.Receiver operating characteristic(ROC)curve analysis was used to determine the predictive value of the logi stic regression model.Results:A total of 346 padients met the inclusion criteria.There were 150 patients with MBL.Tumor stage 3/4(P<0.001),American Society of Aneshesiologists(ASA)score 23(P=0.044),ascites volume≥500 ml(P=0.002),radical or ultra radical surgery(P=0.002),and diabetes(P=0.035)were independent risk factors for MBL in patients with ovarian cancer.The logistic regression combined model of these five factors is more reliable in the prediction of MBL with an area under the ROC curve of 0.729 than the tumor stage(ROC curve=0.645)and surgical complexity(ROC curve=0.568).Conclusion:In padients with ovarian cancer,five risk factors for major intraoperative bleeding were identified.Planned surgical procedures and preoperative risk factors can be used to predict perioperative blood requir ements.展开更多
<strong>Introduction:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> This study evaluated ...<strong>Introduction:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> This study evaluated the difference in operative and clinica</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">l outc</span><span style="font-family:Verdana;">omes for patients with advanced ovarian cancer after primary debulking</span><span style="font-family:Verdana;"> surgery (PDS) versus neoadjuvant chemotherapy (NACT) followed by interval debul</span><span><span style="font-family:Verdana;">king surgery (IDS) in Bangladesh. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Sixty patients with a</span></span><span style="font-family:Verdana;">dvanced epit</span><span style="font-family:Verdana;">helial ovarian cancer presenting to the department of Gynaecologi</span><span style="font-family:Verdana;">cal Oncology at the National Institute of Cancer Research and Hospital were prospectively enrolled. Thirty patients underwent primary debulking surgery and thirty patients received NACT followed by IDS. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In the PDS and IDS groups respectively, 56.7% and 50% of patients presented with stage IIIC and 67.7% and 56.7% respectively had ser</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">i</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ous papillary type histopathology. Duration of surgery, amount of blood loss and total hospital stay were significantly lower (p < 0.001) in IDS group than </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">in </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">the PDS group. There was a statistically significant difference in postoperative tumor residuals between IDS and PDS patients. Complete tumor resection (R0) was obtained in 24 (80%) of IDS patients versus 13 (43.3%) PDS patients. In fifteen months of follow-up, 21 (70%) in the PDS group and 5 (16.7%) in the IDS group recurred (</span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> = 0.021). Median progression free survival in PDS patients was twelve months while that of the IDS group was seventeen months. There was one death at 45 days in the PDS group. No other deaths were documented at fifteen months of follow-up. </span><b><span style="font-family:Verdana;">Conclusion</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Interval debulking surgery has a more favorable outcome than primary debulking surgery on progression free survival in advanced ovarian cancer patients </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">and </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">permits a less aggressive surgery to be performed in Bangladesh.</span></span></span>展开更多
基金the National Key Research and Development Program of China(No.2016YFA0201404)Natural Science Foundation of Beijing(7222204).
文摘Objective:The goal of this study was to find the risk factors for major intraoperative blood loss(MBL)of pr imary debulking surgery(PDS)for ovarian cancer.Methods:Patients wi th ovarian cancer who underwent PDS in our hospital,from 2010 to 2017,were enrolled.The association between risk factors and MBL was modeled with the use of logisde regr ession.Receiver operating characteristic(ROC)curve analysis was used to determine the predictive value of the logi stic regression model.Results:A total of 346 padients met the inclusion criteria.There were 150 patients with MBL.Tumor stage 3/4(P<0.001),American Society of Aneshesiologists(ASA)score 23(P=0.044),ascites volume≥500 ml(P=0.002),radical or ultra radical surgery(P=0.002),and diabetes(P=0.035)were independent risk factors for MBL in patients with ovarian cancer.The logistic regression combined model of these five factors is more reliable in the prediction of MBL with an area under the ROC curve of 0.729 than the tumor stage(ROC curve=0.645)and surgical complexity(ROC curve=0.568).Conclusion:In padients with ovarian cancer,five risk factors for major intraoperative bleeding were identified.Planned surgical procedures and preoperative risk factors can be used to predict perioperative blood requir ements.
文摘<strong>Introduction:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> This study evaluated the difference in operative and clinica</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">l outc</span><span style="font-family:Verdana;">omes for patients with advanced ovarian cancer after primary debulking</span><span style="font-family:Verdana;"> surgery (PDS) versus neoadjuvant chemotherapy (NACT) followed by interval debul</span><span><span style="font-family:Verdana;">king surgery (IDS) in Bangladesh. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Sixty patients with a</span></span><span style="font-family:Verdana;">dvanced epit</span><span style="font-family:Verdana;">helial ovarian cancer presenting to the department of Gynaecologi</span><span style="font-family:Verdana;">cal Oncology at the National Institute of Cancer Research and Hospital were prospectively enrolled. Thirty patients underwent primary debulking surgery and thirty patients received NACT followed by IDS. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In the PDS and IDS groups respectively, 56.7% and 50% of patients presented with stage IIIC and 67.7% and 56.7% respectively had ser</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">i</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ous papillary type histopathology. Duration of surgery, amount of blood loss and total hospital stay were significantly lower (p < 0.001) in IDS group than </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">in </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">the PDS group. There was a statistically significant difference in postoperative tumor residuals between IDS and PDS patients. Complete tumor resection (R0) was obtained in 24 (80%) of IDS patients versus 13 (43.3%) PDS patients. In fifteen months of follow-up, 21 (70%) in the PDS group and 5 (16.7%) in the IDS group recurred (</span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> = 0.021). Median progression free survival in PDS patients was twelve months while that of the IDS group was seventeen months. There was one death at 45 days in the PDS group. No other deaths were documented at fifteen months of follow-up. </span><b><span style="font-family:Verdana;">Conclusion</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Interval debulking surgery has a more favorable outcome than primary debulking surgery on progression free survival in advanced ovarian cancer patients </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">and </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">permits a less aggressive surgery to be performed in Bangladesh.</span></span></span>
