Violante Di Donato1, Evangelos Kontopantelis2,3, Giovanni Aletti4, Assunta Casorelli5, Ilaria Piacenti5, Giorgio Bogani6, Francesca Lecce5, Pierluigi Benedetti Panici5. 1. Department of Gynecology Obstetrics and Urology, Policlinico Umberto I, ''Sapienza'' University of Rome, Rome, Italy. violante.didonato@uniroma1.it. 2. The Farr Institute for Health Informatics Research, University of Manchester, Manchester, UK. 3. The National Institute for Health Research, School for Primary Care Research, Radcliffe Observatory Quarter, Oxford, UK. 4. Division of Medical Gynecologic Oncology, European Institute of Oncology, Milan, Italy. 5. Department of Gynecology Obstetrics and Urology, Policlinico Umberto I, ''Sapienza'' University of Rome, Rome, Italy. 6. Gynecologic Surgery Unit, IRCCS Foundation, National Cancer Institute, Milan, Italy.
Abstract
BACKGROUND: Primary cytoreductive surgery (PDS) followed by platinum-based chemotherapy is the cornerstone of treatment and the absence of residual tumor after PDS is universally considered the most important prognostic factor. The aim of the present analysis was to evaluate trend and predictors of 30-day mortality in patients undergoing primary cytoreduction for ovarian cancer. METHODS: Literature was searched for records reporting 30-day mortality after PDS. All cohorts were rated for quality. Simple and multiple Poisson regression models were used to quantify the association between 30-day mortality and the following: overall or severe complications, proportion of patients with stage IV disease, median age, year of publication, and weighted surgical complexity index. Using the multiple regression model, we calculated the risk of perioperative mortality at different levels for statistically significant covariates of interest. RESULTS: Simple regression identified median age and proportion of patients with stage IV disease as statistically significant predictors of 30-day mortality. When included in the multiple Poisson regression model, both remained statistically significant, with an incidence rate ratio of 1.087 for median age and 1.017 for stage IV disease. Disease stage was a strong predictor, with the risk estimated to increase from 2.8% (95% confidence interval 2.02-3.66) for stage III to 16.1% (95% confidence interval 6.18-25.93) for stage IV, for a cohort with a median age of 65 years. CONCLUSIONS: Metaregression demonstrated that increased age and advanced clinical stage were independently associated with an increased risk of mortality, and the combined effects of both factors greatly increased the risk.
BACKGROUND: Primary cytoreductive surgery (PDS) followed by platinum-based chemotherapy is the cornerstone of treatment and the absence of residual tumor after PDS is universally considered the most important prognostic factor. The aim of the present analysis was to evaluate trend and predictors of 30-day mortality in patients undergoing primary cytoreduction for ovarian cancer. METHODS: Literature was searched for records reporting 30-day mortality after PDS. All cohorts were rated for quality. Simple and multiple Poisson regression models were used to quantify the association between 30-day mortality and the following: overall or severe complications, proportion of patients with stage IV disease, median age, year of publication, and weighted surgical complexity index. Using the multiple regression model, we calculated the risk of perioperative mortality at different levels for statistically significant covariates of interest. RESULTS: Simple regression identified median age and proportion of patients with stage IV disease as statistically significant predictors of 30-day mortality. When included in the multiple Poisson regression model, both remained statistically significant, with an incidence rate ratio of 1.087 for median age and 1.017 for stage IV disease. Disease stage was a strong predictor, with the risk estimated to increase from 2.8% (95% confidence interval 2.02-3.66) for stage III to 16.1% (95% confidence interval 6.18-25.93) for stage IV, for a cohort with a median age of 65 years. CONCLUSIONS: Metaregression demonstrated that increased age and advanced clinical stage were independently associated with an increased risk of mortality, and the combined effects of both factors greatly increased the risk.
Authors: Stephanie Cham; Ling Chen; Caryn M St Clair; June Y Hou; Ana I Tergas; Alexander Melamed; Cande V Ananth; Alfred I Neugut; Dawn L Hershman; Jason D Wright Journal: Am J Obstet Gynecol Date: 2019-02-13 Impact factor: 8.661
Authors: Violante Di Donato; Giuseppe Caruso; Marco Petrillo; Evangelos Kontopantelis; Innocenza Palaia; Giorgia Perniola; Francesco Plotti; Roberto Angioli; Ludovico Muzii; Pierluigi Benedetti Panici; Giorgio Bogani Journal: Vaccines (Basel) Date: 2021-04-21
Authors: Myeong-Seon Kim; Seung Hun Baek; Joseph J Noh; Jung In Shim; Jun Hyeok Kang; Soo Young Jeong; Chel Hun Choi; Tae-Joong Kim; Jeong-Won Lee; Yoo-Young Lee Journal: Front Oncol Date: 2022-09-08 Impact factor: 5.738
Authors: Violante Di Donato; Andrea Giannini; Ottavia D'Oria; Michele Carlo Schiavi; Anna Di Pinto; Margherita Fischetti; Francesca Lecce; Giorgia Perniola; Francesco Battaglia; Pasquale Berloco; Ludovico Muzii; Pierluigi Benedetti Panici Journal: Ann Surg Oncol Date: 2020-08-10 Impact factor: 5.344