Predictors of mortality within 1 year after primary ovarian cancer surgery

a nationwide cohort study

Mette Ørskov Sjøland, Maria Iachina, Rikke Guldberg Sørensen, Ole Mogensen, Bente Mertz Nørgård

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Resumé

OBJECTIVES: To identify predictors of mortality within 1 year after primary surgery for ovarian cancer.

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

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

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

OUTCOME MEASURES: 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.

OriginalsprogEngelsk
TidsskriftB M J Open
Vol/bind6
Udgave nummer4
Sider (fra-til)e010123
ISSN2044-6055
DOI
StatusUdgivet - 2016

Fingeraftryk

Ovarian Neoplasms
Cohort Studies
Residual Neoplasm
Gynecology
Obstetrics
Comorbidity
Body Mass Index
Databases

Citer dette

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title = "Predictors of mortality within 1 year after primary ovarian cancer surgery: a nationwide cohort study",
abstract = "OBJECTIVES: To identify predictors of mortality within 1 year after primary surgery for ovarian cancer.DESIGN: Prospective nationwide cohort study from 1 January 2005 to 31 December 2012.SETTING: Evaluation of data from the Danish Gynaecology Cancer Database and the Danish Civil Registration System.PARTICIPANTS: 2654 women who underwent surgery due to a diagnosis of primary ovarian cancer.OUTCOME MEASURES: 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.",
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note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/",
year = "2016",
doi = "10.1136/bmjopen-2015-010123",
language = "English",
volume = "6",
pages = "e010123",
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issn = "2044-6055",
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Predictors of mortality within 1 year after primary ovarian cancer surgery : a nationwide cohort study. / Sjøland, Mette Ørskov; Iachina, Maria; Sørensen, Rikke Guldberg; Mogensen, Ole; Mertz Nørgård, Bente.

I: B M J Open, Bind 6, Nr. 4, 2016, s. e010123.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Predictors of mortality within 1 year after primary ovarian cancer surgery

T2 - a nationwide cohort study

AU - Sjøland, Mette Ørskov

AU - Iachina, Maria

AU - Sørensen, Rikke Guldberg

AU - Mogensen, Ole

AU - Mertz Nørgård, Bente

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PY - 2016

Y1 - 2016

N2 - OBJECTIVES: To identify predictors of mortality within 1 year after primary surgery for ovarian cancer.DESIGN: Prospective nationwide cohort study from 1 January 2005 to 31 December 2012.SETTING: Evaluation of data from the Danish Gynaecology Cancer Database and the Danish Civil Registration System.PARTICIPANTS: 2654 women who underwent surgery due to a diagnosis of primary ovarian cancer.OUTCOME MEASURES: 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.

AB - OBJECTIVES: To identify predictors of mortality within 1 year after primary surgery for ovarian cancer.DESIGN: Prospective nationwide cohort study from 1 January 2005 to 31 December 2012.SETTING: Evaluation of data from the Danish Gynaecology Cancer Database and the Danish Civil Registration System.PARTICIPANTS: 2654 women who underwent surgery due to a diagnosis of primary ovarian cancer.OUTCOME MEASURES: 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.

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

UR - http://bmjopen.bmj.com/content/6/4/e010123.full

U2 - 10.1136/bmjopen-2015-010123

DO - 10.1136/bmjopen-2015-010123

M3 - Journal article

VL - 6

SP - e010123

JO - B M J Open

JF - B M J Open

SN - 2044-6055

IS - 4

ER -