Literature DB >> 25950127

Does a standardized preoperative algorithm of clinical data improve outcomes in patients with ovarian cancer? A quality improvement project.

Monjri M Shah1, Charles A Leath, Laura Rebecca Daily, Gerald McGwin, Jacob M Estes, Ronald D Alvarez, John Michael Straughn.   

Abstract

OBJECTIVE: To evaluate the potential impact of a standardized preoperative algorithm on outcomes of patients with suspected ovarian cancer.
METHODS: From January 1 to December 31, 2013, patients with suspected ovarian cancer were triaged to primary debulking surgery or neoadjuvant chemotherapy/interval debulking surgery (NACT/IDS) based on a comprehensive review of preoperative clinical data as part of a quality improvement project. Demographics, surgical, and postoperative data were collected.
RESULTS: A total of 110 patients with newly diagnosed ovarian cancer were identified: 68 (62%) underwent PDS with an 85% optimal debulking rate. The 30-day readmission rate was 14.7% with a 2.9% 60-day mortality rate. Forty-two patients (38%) underwent NACT. Two patients (4.8%) died before receiving NACT. Thirty-five patients have undergone IDS with an 89% optimal debulking rate. The 30-day readmission rate was 8.5% with a 5.7% 60-day mortality rate after IDS.
CONCLUSIONS: Although it is difficult to predict which patients will undergo optimal debulking at the time of PDS, surgical morbidity and mortality can be decreased by using NACT in select patients. The initiation of a quality improvement project has contributed to an improvement in patient outcomes at our institution.

Entities:  

Mesh:

Year:  2015        PMID: 25950127      PMCID: PMC4441559          DOI: 10.1097/IGC.0000000000000433

Source DB:  PubMed          Journal:  Int J Gynecol Cancer        ISSN: 1048-891X            Impact factor:   3.437


  20 in total

1.  Intraperitoneal cisplatin and paclitaxel in ovarian cancer.

Authors:  Deborah K Armstrong; Brian Bundy; Lari Wenzel; Helen Q Huang; Rebecca Baergen; Shashikant Lele; Larry J Copeland; Joan L Walker; Robert A Burger
Journal:  N Engl J Med       Date:  2006-01-05       Impact factor: 91.245

2.  Complete cytoreductive surgery is feasible and maximizes survival in patients with advanced epithelial ovarian cancer: a prospective study.

Authors:  S M Eisenkop; R L Friedman; H J Wang
Journal:  Gynecol Oncol       Date:  1998-05       Impact factor: 5.482

3.  Multi-institutional reciprocal validation study of computed tomography predictors of suboptimal primary cytoreduction in patients with advanced ovarian cancer.

Authors:  Allison E Axtell; Margaret H Lee; Robert E Bristow; Sean C Dowdy; William A Cliby; Steven Raman; John P Weaver; Mojan Gabbay; Michael Ngo; Scott Lentz; Ilana Cass; Andrew J Li; Beth Y Karlan; Christine H Holschneider
Journal:  J Clin Oncol       Date:  2007-02-01       Impact factor: 44.544

4.  Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis.

Authors:  Robert E Bristow; Rafael S Tomacruz; Deborah K Armstrong; Edward L Trimble; F J Montz
Journal:  J Clin Oncol       Date:  2002-03-01       Impact factor: 44.544

Review 5.  Delaying the primary surgical effort for advanced ovarian cancer: a systematic review of neoadjuvant chemotherapy and interval cytoreduction.

Authors:  Robert E Bristow; Eric L Eisenhauer; Antonio Santillan; Dennis S Chi
Journal:  Gynecol Oncol       Date:  2006-12-12       Impact factor: 5.482

6.  A contemporary analysis of the ability of preoperative serum CA-125 to predict primary cytoreductive outcome in patients with advanced ovarian, tubal and peritoneal carcinoma.

Authors:  Dennis S Chi; Oliver Zivanovic; Meena J Palayekar; Eric L Eisenhauer; Nadeem R Abu-Rustum; Yukio Sonoda; Douglas A Levine; Mario M Leitao; Carol L Brown; Richard R Barakat
Journal:  Gynecol Oncol       Date:  2009-01       Impact factor: 5.482

7.  Nutritional assessment using prealbumin as an objective criterion to determine whom should not undergo primary radical cytoreductive surgery for ovarian cancer.

Authors:  John P Geisler; Georgiann C Linnemeier; Amanda J Thomas; Kelly J Manahan
Journal:  Gynecol Oncol       Date:  2007-04-26       Impact factor: 5.482

Review 8.  Predicting the outcome of cytoreductive surgery for advanced ovarian cancer: a review.

Authors:  Okechukwu A Ibeanu; Robert E Bristow
Journal:  Int J Gynecol Cancer       Date:  2010-01       Impact factor: 3.437

9.  CA125 levels are a weak predictor of optimal cytoreductive surgery in patients with advanced epithelial ovarian cancer.

Authors:  S Memarzadeh; S B Lee; J S Berek; R Farias-Eisner
Journal:  Int J Gynecol Cancer       Date:  2003 Mar-Apr       Impact factor: 3.437

10.  Prediction of suboptimal primary cytoreduction in primary ovarian cancer with combined positron emission tomography/computed tomography--a prospective study.

Authors:  S Risum; C Høgdall; A Loft; A K Berthelsen; E Høgdall; L Nedergaard; L Lundvall; S A Engelholm
Journal:  Gynecol Oncol       Date:  2007-12-04       Impact factor: 5.482

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