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Surgical Complexity Affects Ovarian Cancer Outcomes

Despite higher risk of complications, more complex surgery carries an overall survival benefit

MONDAY, Jan. 7 (HealthDay News) -- In patients with advanced ovarian cancer who undergo primary surgery, factors such as surgical complexity have a significant effect on short-term morbidity and overall survival, according to a report published in the December issue of the American Journal of Obstetrics & Gynecology.

Giovanni D. Aletti, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues studied 219 patients with stage IIIC-IV ovarian cancer.

The researchers found that poor performance status, age, and extent or complexity of surgery were all independently associated with major morbidity. They found that age and performance status -- but not surgical complexity -- predicted three-month mortality. They also observed that surgical complexity independently predicted overall survival. Among the risk prediction categories developed by the researchers, the risk of expected complications ranged from 2.5 percent to 67.6 percent. In all risk groups, however, more complex surgery carried a survival benefit.

"Because of the survival benefit from lower residual disease, a less aggressive surgical effort results in poorer overall survival," the authors conclude. "However, the risk of complications are substantial for complex surgeries in the highest-risk patients: risk stratification should be used to help plan perioperative care and consider optimal treatment planning."

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