Abstract：
To evaluate procedures performed during primary debulking surgery (PDS) and interval debulking surgery (IDS) for ovarian cancer.
Patients surgically treated at our institution for newly diagnosed stage IIIC/IV epithelial ovarian cancer between 6/1/2015-12/31/2021 were identified using a prospectively collected database. Patients were triaged to PDS or neoadjuvant chemotherapy (NACT) followed by IDS using an institutional algorithm. Data on specific procedures performed, including consultants called, were collected from operative and pathology reports. Appropriate statistical analyses were applied.
Overall, 467 patients underwent PDS and 434 underwent IDS; 76% (PDS) and 71% (IDS) of cases achieved complete gross resection. Comparing PDS vs IDS cohorts, median age was 63 years (range, 23-86) vs 67 years (range, 35-95), 79% vs 86% of patients had high-grade serous histology, and 38% vs 70% had stage IV disease. Most procedures (except ostomy, distal pancreatectomy) were more common during PDS (P < .05). Bowel surgery was performed during 65% of PDS and 33% of IDS, and upper abdominal surgery during 72% of PDS and 52% of IDS; both were more common during PDS (P < .001). Estimated blood loss (median, 500 mL [PDS] vs 300 mL [IDS]) and operative time (median, 362 min [PDS] vs 267 min [IDS]) were higher for PDS (P < .001). A consulting surgeon was utilized during 31% of PDS and 18% of IDS, with hepatopancreaticobiliary as the most commonly called service (61% and 65%, respectively).
In our study of patients with advanced-stage ovarian cancer, while most procedures were more often performed during PDS, NACT did not obviate the need for radical surgical resection. Thus, advanced surgical skills remain essential.
Patients surgically treated at our institution for newly diagnosed stage IIIC/IV epithelial ovarian cancer between 6/1/2015-12/31/2021 were identified using a prospectively collected database. Patients were triaged to PDS or neoadjuvant chemotherapy (NACT) followed by IDS using an institutional algorithm. Data on specific procedures performed, including consultants called, were collected from operative and pathology reports. Appropriate statistical analyses were applied.
Overall, 467 patients underwent PDS and 434 underwent IDS; 76% (PDS) and 71% (IDS) of cases achieved complete gross resection. Comparing PDS vs IDS cohorts, median age was 63 years (range, 23-86) vs 67 years (range, 35-95), 79% vs 86% of patients had high-grade serous histology, and 38% vs 70% had stage IV disease. Most procedures (except ostomy, distal pancreatectomy) were more common during PDS (P < .05). Bowel surgery was performed during 65% of PDS and 33% of IDS, and upper abdominal surgery during 72% of PDS and 52% of IDS; both were more common during PDS (P < .001). Estimated blood loss (median, 500 mL [PDS] vs 300 mL [IDS]) and operative time (median, 362 min [PDS] vs 267 min [IDS]) were higher for PDS (P < .001). A consulting surgeon was utilized during 31% of PDS and 18% of IDS, with hepatopancreaticobiliary as the most commonly called service (61% and 65%, respectively).
In our study of patients with advanced-stage ovarian cancer, while most procedures were more often performed during PDS, NACT did not obviate the need for radical surgical resection. Thus, advanced surgical skills remain essential.
摘要：
目的：评估卵巢癌原发减瘤手术（PDS）和间隔减瘤手术（IDS）期间的操作。
方法：使用前瞻性收集的数据库对2015年6月1日至2021年12月31日期间在我们机构接受手术治疗的新诊断IIIC/IV期上皮性卵巢癌患者进行鉴定。使用机构算法对患者进行PDS或新辅助化疗（NACT），然后进行IDS。执行的特定程序的数据，包括打电话来的顾问，从手术和病理报告中收集。采用适当的统计分析。
结果：总体而言，467例患者接受了PDS，434例接受了IDS；76％（PDS）和71％（IDS）的病例完全切除。比较PDS和IDS队列，中位年龄为63岁(范围，23-86）vs67岁（范围，35-95），79%vs86%的患者有高级别浆液性组织学，38%vs70%患有IV期疾病。大多数程序（造口术除外，远端胰腺切除术）在PDS期间更常见（P<.05）。在65%的PDS和33%的IDS期间进行了肠道手术，在72％的PDS和52％的IDS期间进行上腹部手术；两者在PDS期间更为常见（P<0.001）。估计失血量（中位数，500毫升[PDS]vs300毫升[IDS]）和手术时间（中位数，PDS的362分钟[PDS]对267分钟[IDS]）较高（P<.001）。在31%的PDS和18%的IDS期间使用了咨询外科医生，肝胰胆管是最常见的服务(61%和65%，分别)。
结论：在我们对晚期卵巢癌患者的研究中，虽然大多数手术在PDS期间更频繁地进行，NACT并未消除根治性手术切除的需要。因此，先进的手术技能仍然至关重要。
方法：使用前瞻性收集的数据库对2015年6月1日至2021年12月31日期间在我们机构接受手术治疗的新诊断IIIC/IV期上皮性卵巢癌患者进行鉴定。使用机构算法对患者进行PDS或新辅助化疗（NACT），然后进行IDS。执行的特定程序的数据，包括打电话来的顾问，从手术和病理报告中收集。采用适当的统计分析。
结果：总体而言，467例患者接受了PDS，434例接受了IDS；76％（PDS）和71％（IDS）的病例完全切除。比较PDS和IDS队列，中位年龄为63岁(范围，23-86）vs67岁（范围，35-95），79%vs86%的患者有高级别浆液性组织学，38%vs70%患有IV期疾病。大多数程序（造口术除外，远端胰腺切除术）在PDS期间更常见（P<.05）。在65%的PDS和33%的IDS期间进行了肠道手术，在72％的PDS和52％的IDS期间进行上腹部手术；两者在PDS期间更为常见（P<0.001）。估计失血量（中位数，500毫升[PDS]vs300毫升[IDS]）和手术时间（中位数，PDS的362分钟[PDS]对267分钟[IDS]）较高（P<.001）。在31%的PDS和18%的IDS期间使用了咨询外科医生，肝胰胆管是最常见的服务(61%和65%，分别)。
结论：在我们对晚期卵巢癌患者的研究中，虽然大多数手术在PDS期间更频繁地进行，NACT并未消除根治性手术切除的需要。因此，先进的手术技能仍然至关重要。
