title: Multi-center evaluation of post-operative morbidity and mortality after optimal cytoreductive surgery for advanced ovarian cancer.
abstract: OBJECTIVE
  While optimal cytoreduction is the standard of care for advanced ovarian cancer, the related post-operative morbidity has not been clearly documented outside pioneering centers. Indeed most of the studies are monocentric with inclusions over several years inducing heterogeneity in techniques and goals of surgery. We assessed the morbidity of optimal cytoreduction surgery for advanced ovarian cancer within a short inclusion period in 6 referral centers dedicated to achieve complete cytoreduction.
  
  
  METHODS
  The 30 last optimal debulking surgeries of 6 cancer centers were included. Inclusion criteria included: stage IIIc- IV ovarian cancer and optimal surgery performed at the site of inclusion. All post-operative complications within 30 days of surgery were recorded and graded using the Memorial secondary events grading system. Student-t, Chi2 and non-parametric statistical tests were performed.
  
  
  RESULTS
  180 patients were included. There was no demographic differences between the centers. 63 patients underwent surgery including intestinal resections (58 recto-sigmoid resection), 24 diaphragmatic resections, 17 splenectomies. 61 patients presented complications; One patient died post-operatively. Major (grade 3-5) complications requiring subsequent surgeries occurred in 21 patients (11.5%). 76% of patients with a major complication had undergone an ultraradical surgery (P = 0.004).
  
  
  CONCLUSIONS
  While ultraradical surgery may result in complete resection of peritoneal disease in advanced ovarian cancer, the associated complication rate is not negligible. Patients should be carefully evaluated and the timing of their surgery optimized in order to avoid major complications.
authors: Institut Claudius Regaud, Toulouse, France. jat2021@qatar-med.cornell.edu
authors: Arash
authors: A
authors: Rafii
authors: Eberhard
authors: E
authors: Stoeckle
authors: Mehdi
authors: M
authors: Jean-Laurent
authors: Gwenael
authors: G
authors: Ferron
authors: Philippe
authors: P
authors: Morice
authors: Gilles
authors: G
authors: Houvenaeghel
authors: Fabrice
authors: F
authors: Lecuru
authors: Eric
authors: E
authors: Leblanc
authors: Denis
authors: D
authors: Querleu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality*; D012017:Referral and Consultation; D012189:Retrospective Studies; D055815:Young Adult