Predictors of mortality within 1 year after primary ovarian cancer surgery: a nationwide cohort study.
OBJECTIVE
To identify predictors of mortality within 1 year after primary surgery for ovarian cancer.


METHODS
Prospective nationwide cohort study from 1 January 2005 to 31 December 2012.


METHODS
Evaluation of data from the Danish Gynaecology Cancer Database and the Danish Civil Registration System.


METHODS
2654 women who underwent surgery due to a diagnosis of primary ovarian cancer.


METHODS
Overall survival and predictors of mortality within 0-180 and 181-360 days after the primary surgery. Examined predictors were age, preoperative American Society of Anesthesiologists (ASA) score, body mass index (BMI), International Federation of Gynaecology and Obstetrics (FIGO) stage, residual tumour tissue after surgery, perioperative blood transfusion and calendar year of surgery.


RESULTS
The overall 1-year survival was 84%. Within 0-180 days after surgery, the 3 most important predictors of mortality from the multivariable model were residual tumour tissue >2 cm versus no residual tumour (HR=4.58 (95% CI 3.20 to 6.59)), residual tumour tissue ≤2 cm versus no residual tumour (HR=2.50 (95% CI 1.63 to 3.82)) and age >64 years versus age ≤64 years (HR=2.33 (95% CI 1.69 to 3.21)). Within 181-360 days after surgery, FIGO stages III-IV versus I-II (HR=2.81 (95% CI 1.75 to 4.50)), BMI<18.5 vs 18.5-25 kg/m(2) (HR=2.08 (95% CI 1.18 to 3.66)) and residual tumour tissue >2 cm versus no residual tumour (HR=1.84 (95% CI 1.25 to 2.70)) were the 3 most important predictors.


CONCLUSIONS
The most important predictors of mortality within 1 year after surgery were residual tumour tissue (0-180 days after surgery) and advanced FIGO stage (181-360 days after surgery). However, our results suggest that the surgeon should not just aim at radical surgery, but also pay special attention to comorbidity, nutritional state, age >64 years and the need for perioperative blood transfusion.
Research Unit of Gynecology, Department of Gynecology and Obstetrics, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Mette
M
Ørskov
Research Unit of Clinical Epidemiology, Centre for Clinical Epidemiology Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Maria
M
Iachina
Research Unit of Clinical Epidemiology, Centre for Clinical Epidemiology Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Rikke
R
Guldberg
Research Unit of Gynecology, Department of Gynecology and Obstetrics, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Ole
O
Mogensen
Research Unit of Clinical Epidemiology, Centre for Clinical Epidemiology Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Bente
B
Mertz Nørgård
D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D018365:Neoplasm, Residual; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis
Mortality; Ovarian cancer; Predictors; SURGERY