BibTex format
@article{Fotopoulou:2016:10.1007/s00404-016-4080-3,
author = {Fotopoulou, C and Jones, BP and Savvatis, K and Campbell, J and Kyrgiou, M and Farthing, A and Brett, S and Roux, R and Hall, M and Rustin, G and Gabra, H and Jiao, L and Stumpfle, R},
doi = {10.1007/s00404-016-4080-3},
journal = {Gynecologic Oncology},
title = {Maximal effort cytoreductive surgery for disseminated ovarian cancer in a UK setting: challenges and possibilities},
url = {http://dx.doi.org/10.1007/s00404-016-4080-3},
year = {2016}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - OBJECTIVE: To assess surgical morbidity and mortality of maximal effort cytoreductive surgery for disseminated epithelial ovarian cancer (EOC) in a UK tertiary center. METHODS/MATERIALS: A monocentric prospective analysis of surgical morbidity and mortality was performed for all consecutive EOC patients who underwent extensive cytoreductive surgery between 01/2013 and 12/2014. Surgical complexity was assessed by the Mayo clinic surgical complexity score (SCS). Only patients with high SCS ≥5 were included in the analysis. RESULTS: We evaluated 118 stage IIIC/IV patients, with a median age of 63 years (range 19-91); 47.5 % had ascites and 29 % a pleural effusion. Median duration of surgery was 247 min (range 100-540 min). Median surgical complexity score was 10 (range 5-15) consisting of bowel resection (71 %), stoma formation (13.6 %), diaphragmatic stripping/resection (67 %), liver/liver capsule resection (39 %), splenectomy (20 %), resection stomach/lesser sac (26.3 %), pleurectomy (17 %), coeliac trunk/subdiaphragmatic lymphadenectomy (8 %). Total macroscopic tumor clearance rate was 89 %. Major surgical complication rate was 18.6 % (n = 22), with a 28-day and 3-month mortality of 1.7 and 3.4 %, respectively. The anastomotic leak rate was 0.8 %; fistula/bowel perforation 3.4 %; thromboembolism 3.4 % and reoperation 4.2 %. Median intensive care unit and hospital stay were 1.7 (range 0-104) and 8 days (range 4-118), respectively. Four patients (3.3 %) failed to receive chemotherapy within the first 8 postoperative weeks. CONCLUSIONS: Maximal effort cytoreductive surgery for EOC is feasible within a UK setting with acceptable morbidity, low intestinal stoma rates and without clinically relevant delays to postoperative chemotherapy. Careful patient selection, and coordinated multidisciplinary effort appear to be the key for good outcome. Future ev
AU - Fotopoulou,C
AU - Jones,BP
AU - Savvatis,K
AU - Campbell,J
AU - Kyrgiou,M
AU - Farthing,A
AU - Brett,S
AU - Roux,R
AU - Hall,M
AU - Rustin,G
AU - Gabra,H
AU - Jiao,L
AU - Stumpfle,R
DO - 10.1007/s00404-016-4080-3
PY - 2016///
SN - 1095-6859
TI - Maximal effort cytoreductive surgery for disseminated ovarian cancer in a UK setting: challenges and possibilities
T2 - Gynecologic Oncology
UR - http://dx.doi.org/10.1007/s00404-016-4080-3
UR - http://hdl.handle.net/10044/1/31028
ER -
Critical care involves the care of the sickest patients in the hospital. Critically ill patients have usually been through a significant insult to their body (such as trauma, infection, burn) and have developed organ failure and require life-support. Critical Care is the largest theme bringing together clinicians and scientists from diverse backgrounds and includes collaborative research from hospitals throughout north-west London. Investigations range from evaluating biological mechanisms of organ failure through to the development of innovative technologies which allow the short-term and long-term support and recovery of organs.