Days alive and out of hospital after surgical treatment of epithelial ovarian cancer: A Danish nationwide cohort study.

Autor: Ekmann-Gade AW; Department of Gynecology, Rigshospitalet, Copenhagen, Denmark. Electronic address: anne.weng.ekmann-gade@regionh.dk., Høgdall C; Department of Gynecology, Rigshospitalet, Copenhagen, Denmark., Seibæk L; Department of Gynecology, Aarhus University Hospital, Aarhus, Denmark., Noer MC; Department of Gynecology and Obstetrics, Herlev University Hospital, Herlev, Denmark., Rasmussen A; Department of Gynecology, Rigshospitalet, Copenhagen, Denmark., Schnack TH; Department of Gynecology, Odense University Hospital, Odense, Denmark.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2023 Oct; Vol. 49 (10), pp. 107039. Date of Electronic Publication: 2023 Aug 22.
DOI: 10.1016/j.ejso.2023.107039
Abstrakt: Objective: Days alive and out of hospital (DAOH) is a validated outcome measure in perioperative trials integrating information on primary hospitalization, readmissions, and mortality. It is negatively associated with advanced age. However, DAOH has not been described for surgical treatment of epithelial ovarian cancer (EOC), primarily diagnosed in older patients.
Methods: We conducted a Danish nationwide cohort study including patients undergoing debulking surgery for EOC from 2013 to 2018. DAOH was explored for 30 (DAOH30), 90 (DAOH90), and 180 (DAOH180) postoperative days in younger (<70 years) and older (≥70 years) patients with advanced-stage disease stratified by surgical modality (primary (PDS) or interval debulking surgery (IDS)). We examined the associations between patient- and surgical outcomes and low or high DAOH30.
Results: Overall, 1168 patients had stage IIIC-IV disease and underwent debulking surgery. DAOH30 was 22 days [interquartile range (IQR): 18, 25] and 23 days [IQR: 18, 25] for younger and older patients treated with PDS, respectively. For IDS, DAOH30 was 25 days [IQR: 22, 26] for younger and 25 days[IQR: 21, 26] for older patients. We found no significant differences between age cohorts regarding DAOH30, DAOH90, and DAOH180. Low DAOH30 was associated with poor performance status, PDS, extensive surgery, and long duration of surgery in adjusted analysis.
Conclusions: DAOH did not differ significantly between age cohorts. Surgical rather than patient-related factors were associated with low DAOH30. Our results likely reflect a high selection of fit older patients for surgery, reducing the patient-related differences between younger and older patients receiving surgical treatment.
(© 2023 Published by Elsevier Ltd.)
Databáze: MEDLINE
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