title: Prognostic significance of postoperative morbidities in patients with advanced epithelial ovarian cancer treated with neoadjuvant chemotherapy and delayed primary surgical debulking.
abstract: BACKGROUND
  To examine the prognostic significance of postoperative morbidities in patients with ovarian cancer treated with neoadjuvant chemotherapy and interval surgical debulking.
  
  
  METHODS
  Retrospective chart reviews of all patients treated with neoadjuvant chemotherapy and interval debulking were performed from 1999 to 2002. Descriptive statistics were used to summarize the distributions of important clinical variables. Logistic regression was used to identify statistically significant predictors of postoperative morbidities. Cox regression was used to model time to first clinical progression. Survivals were estimated by the Kaplan-Meier method and compared with the log rank test. P < .05 was considered to be statistically significant.
  
  
  RESULTS
  Fifty-eight patients were treated with neoadjuvant platinum-taxane combination chemotherapy. Major surgical complications were observed in four patients (6.8%). There were no perioperative deaths. The presence of concurrent medical comorbidities was associated with the development of significant postoperative morbidities (P = .038). Cox regression showed any macroscopic residual disease (P = .04) and the presence of significant postoperative morbidities (odds ratio, 4.7, 95% confidence interval, 1.8-12.7, P = .002) to be predictive of a shorter progression-free interval.
  
  
  CONCLUSIONS
  Neoadjuvant chemotherapy followed by interval surgical debulking carried a low risk for postoperative morbidity. The adverse influence of marked postoperative morbidity on progression-free survival needs further study.
authors.affiliation: Division of Gynecologic Oncology, Ottawa General Hospital, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6. tle@ottawahospital.on.ca
authors.forename: Tien
authors.initials: T
authors.lastname: Le
authors.forename: Ghadeer
authors.initials: G
authors.lastname: Alshaikh
authors.forename: Laura
authors.initials: L
authors.lastname: Hopkins
authors.forename: Wylam
authors.initials: W
authors.lastname: Faught
authors.forename: Michael Fung Kee
authors.initials: MF
authors.lastname: Fung
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D018269:Carcinoma, Endometrioid / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate