The role of factor XIII in surgery for advanced stage of epithelial ovarian cancer
| Autor: | Philipp Harter, Ulrich Brüß, Harald Groeben, Thaïs Baert, Mahtab Yazdian, Alexander Traut, Mareike Bommert, Uwe Wagner, Andreas du Bois, Richard Schwameis, Beyhan Ataseven, Stephanie Schneider, Alexandra Elfers-Wassenhoven |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Carcinoma Ovarian Epithelial Group A Group B Postoperative Complications Ascites Humans Medicine Risk factor Retrospective Studies Ovarian Neoplasms Factor VIII Factor XIII business.industry Obstetrics and Gynecology Histology General Medicine medicine.disease Factor XIII Deficiency Surgery Serous fluid Female medicine.symptom business Ovarian cancer medicine.drug |
| Zdroj: | Archives of Gynecology and Obstetrics. 305:1311-1318 |
| ISSN: | 1432-0711 |
| DOI: | 10.1007/s00404-021-06308-z |
| Popis: | Hereditary factor (F) XIII-deficiency is a known risk factor for postoperative complications, but data of acquired FXIII-deficiency in malignancies are limited. Therefore, we evaluated the role of acquired FXIII-deficiency in surgery for advanced epithelial ovarian cancer (EOC).We performed a retrospective analysis of patients with known serum FXIII status and treatment between 2011 and 2018 at our center. We defined cohorts according to FXIII with values 75% as normal (group A), 55-75% as reduced (group B) and 55% as low (group C). Complications were classified according to the Clavien-Dindo Classification, class III-V complications were defined as severe.347 patients with EOC were identified. 180 patients (51.2%) were in group A, 82 patients (23.6%) in group B, and 85 patients (24.4%) in group C. Lower levels of FXIII were associated with higher amount of ascites, FIGO IV, high grade serous histology, low albumin, and higher CA-125 levels. Regarding intraoperative variables, low FXIII was associated with longer duration of surgery, higher blood loss, higher surgical complexity score/number of bowel anastomosis and a higher probability for macroscopic residual disease. The risk of severe complications in group A was 12.2%, 24.4% in group B, and 31.8% in group C. In a multivariate model, low FXIII (OR 2.8), 1 bowel anastomosis (OR 2.7), age-adjusted Charlson comorbidity index ≥ 4 (OR 3.6) and a longer duration of surgery ( 285 min.) were significant predictive factors for severe complications.FXIII is associated with tumor and treatment burden. A low level of FXIII is associated with postoperative complications. The knowledge about the presurgical serum FXIII-level might be helpful to plan the treatment strategy. |
| Databáze: | OpenAIRE |
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