A K Sinno1, X Li2, R E Thompson2, E J Tanner3, K L Levinson3, R L Stone3, S M Temkin3, A N Fader3, D S Chi4, K Long Roche4. 1. Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA; Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Olive View-UCLA Medical Center, USA. Electronic address: asinno@dhs.lacounty.gov. 2. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 3. Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA. 4. Department of Gynecologic Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Abstract
OBJECTIVES: To describe the US national trends and factors associated with cytoreductive surgical radicality in women with advanced ovarian cancer (OC). METHODS: An analysis of the National Inpatient Sample database was performed. All admissions from 1993 to 2011 for advanced OC cytoreductive surgery (CRS) were identified and categorized as simple pelvic (SP), extensive pelvic (EP), and extensive upper abdominal (EUA) surgery. Annual trends in CRS were analyzed. Associations between patient- and hospital-specific factors, with CRS radicality as well as perioperative complications were explored between 2007 and 2011. RESULTS: In total, 28,677 un-weighted admissions were analyzed. The rate of EP and EUA resections increased over time (8% to 18.1% and 1.3% to 5.4%, P<0.01, respectively). On multivariate analysis, patients were more likely to undergo EUA resections in the Northeast (OR 1.44) or West Coast (OR 1.47) at urban (OR 2.3), or large hospitals (OR 1.4), or if they had private insurance (OR 1.45). EUA surgeries were performed more frequently at high-volume ovarian cancer centers (OR 2.65); additionally, fewer complications were observed after EUA at high compared with low and medium volume hospitals (10.2%, 21.2%, and 21.7%, respectively; P=0.01). Specifically, patients treated at high volume hospitals experienced lower rates of hemorrhage, vascular/nerve injury, prolonged hospitalization, and non-routine discharge than at lower (P<0.05). CONCLUSIONS: The US rate of radical cytoreductive surgery for advanced ovarian cancer is increasing. At high-volume hospitals, patients receive more radical surgery with fewer complications, supporting further study of a centralized ovarian cancer care model. Published by Elsevier Inc.
OBJECTIVES: To describe the US national trends and factors associated with cytoreductive surgical radicality in women with advanced ovarian cancer (OC). METHODS: An analysis of the National Inpatient Sample database was performed. All admissions from 1993 to 2011 for advanced OC cytoreductive surgery (CRS) were identified and categorized as simple pelvic (SP), extensive pelvic (EP), and extensive upper abdominal (EUA) surgery. Annual trends in CRS were analyzed. Associations between patient- and hospital-specific factors, with CRS radicality as well as perioperative complications were explored between 2007 and 2011. RESULTS: In total, 28,677 un-weighted admissions were analyzed. The rate of EP and EUA resections increased over time (8% to 18.1% and 1.3% to 5.4%, P<0.01, respectively). On multivariate analysis, patients were more likely to undergo EUA resections in the Northeast (OR 1.44) or West Coast (OR 1.47) at urban (OR 2.3), or large hospitals (OR 1.4), or if they had private insurance (OR 1.45). EUA surgeries were performed more frequently at high-volume ovarian cancer centers (OR 2.65); additionally, fewer complications were observed after EUA at high compared with low and medium volume hospitals (10.2%, 21.2%, and 21.7%, respectively; P=0.01). Specifically, patients treated at high volume hospitals experienced lower rates of hemorrhage, vascular/nerve injury, prolonged hospitalization, and non-routine discharge than at lower (P<0.05). CONCLUSIONS: The US rate of radical cytoreductive surgery for advanced ovarian cancer is increasing. At high-volume hospitals, patients receive more radical surgery with fewer complications, supporting further study of a centralized ovarian cancer care model. Published by Elsevier Inc.
Authors: Jason D Wright; Sharyn N Lewin; Israel Deutsch; William M Burke; Xuming Sun; Alfred I Neugut; Thomas J Herzog; Dawn L Hershman Journal: Gynecol Oncol Date: 2011-09-28 Impact factor: 5.482
Authors: Salla Kumpulainen; Tapio Kuoppala; Arto Leminen; Jorma Penttinen; Ulla Puistola; Eero Pukkala; Risto Sankila; Juha Mäkinen; Seija Grénman Journal: Eur J Cancer Date: 2006-01-18 Impact factor: 9.162
Authors: Craig C Earle; Deborah Schrag; Bridget A Neville; K Robin Yabroff; Marie Topor; Angela Fahey; Edward L Trimble; Diane C Bodurka; Robert E Bristow; Michael Carney; Joan L Warren Journal: J Natl Cancer Inst Date: 2006-02-01 Impact factor: 13.506
Authors: Barbara A Goff; Barbara J Matthews; Eric H Larson; C Holly A Andrilla; Michelle Wynn; Denise M Lishner; Laura-Mae Baldwin Journal: Cancer Date: 2007-05-15 Impact factor: 6.860
Authors: Zhaomin Xu; Adan Z Becerra; Carla F Justiniano; Christopher T Aquina; Fergal J Fleming; Francis P Boscoe; Maria J Schymura; Abdulrahman K Sinno; Jessica Chaoul; Gary R Morrow; Lori Minasian; Sarah M Temkin Journal: J Surg Res Date: 2019-09-24 Impact factor: 2.192
Authors: Deanna H Wong; Alexandra L Mardock; Erica N Manrriquez; Tiffany S Lai; Yas Sanaiha; Abdulrahman K Sinno; Peyman Benharash; Joshua G Cohen Journal: PLoS One Date: 2021-12-08 Impact factor: 3.240