title: An audit of cytoreductive surgeries in ovarian cancer from a rural based cancer center.
abstract: OBJECTIVE
  Ovarian cancers are frequently seen at an advanced stage in our center. This audit was planned to see the morbidity and efficacy of different types of cytoreductive surgeries (radical vs. ultra-radical) done in such patients.
  
  
  METHODS
  This was a retrospective analysis of all ovarian cancer patients who underwent cytoreductive surgery at our center from January 2009 to August 2013. The case records of these patients were reviewed and the demographic, disease-related and treatment-related data were extracted.
  
  
  RESULTS
  Fifty-fivepatients were identified. Ten (18.2%) patients underwent primary cytoreduction while 45 patients had (81.8%) interval cytoreduction. The resections achieved were optimal in 50 patients (90.9%) and suboptimal in five patients (9.1%). The postoperative median blood loss was 400 (350-600) mL. The median time interval for surgery was 4.0 h (3-5 h). The type of resection achieved (optimal vs. suboptimal) was the only factor affecting the progression free survival (PFS) (Hazard ratio = 0.08 95% confidence interval 0.02-0.3). There was no significant difference in postoperative morbidity in patients undergoing the ultra-radical surgery as compared to those who underwent radical surgery.
  
  
  CONCLUSIONS
  Optimal cytoreduction may improve PFS in advanced ovarian cancer patients and needs to be done even if it mandates an ultra-radical surgery.
authors.affiliation: Department of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: S B
authors.initials: SB
authors.lastname: Dessai
authors.affiliation: Department of Clinical Hematology and Medical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: V M
authors.initials: VM
authors.lastname: Patil
authors.affiliation: Department of Radiation Oncology, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: S
authors.initials: S
authors.lastname: Chakraborty
authors.affiliation: Department of Imageology, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: S
authors.initials: S
authors.lastname: Babu
authors.affiliation: Department of Cancer Registry, Division of Clinical Research and Biostatistics, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: A
authors.initials: A
authors.lastname: Bhattacharjee
authors.affiliation: Department of Clinical Laboratory Services and Translational Research, Division of Oncopathology, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: S
authors.initials: S
authors.lastname: Nayanar
authors.affiliation: Department of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: S
authors.initials: S
authors.lastname: Vikram
authors.affiliation: Department of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: S
authors.initials: S
authors.lastname: Balasubramanian
mesh_terms: D000328:Adult; D003133:Commission on Professional and Hospital Activities; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D012424:Rural Population