Kristen Pepin1, Amy Bregar2, Michelle Davis3, Alexander Melamed2, Emily Hinchcliff4, Allison Gockley3, Neil Horowitz3, Marcela G Del Carmen2. 1. Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States; Brigham and Women's Hospital, 75 Francis St, Boston, MA 20115, United States. Electronic address: kpepin@partners.org. 2. Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States. 3. Brigham and Women's Hospital, 75 Francis St, Boston, MA 20115, United States. 4. MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, United States.
Abstract
OBJECTIVE: Admissions to intensive care units (ICU) are costly, but are necessary for some patients undergoing radical cancer surgery. When compared to primary debulking surgery (PDS), neoadjuvant chemotherapy (NACT) with interval debulking surgery, is associated with less peri-operative morbidity. In this study, we compare rates, indications and lengths of ICU stays among ovarian cancer patients admitted to the ICU within 30days of cytoreduction, either primary or interval. METHODS: A retrospective chart review was performed of patients with stage III-IV ovarian cancer who underwent surgical cytoreduction at two large academic medical centers between 2010 and 2014. Chi square tests, Student t-tests, and Mann-U Whitney tests were used. RESULTS: A total of 635 patients were included in the study. There were 43 ICU admissions, 7% of patients. Compared to NACT, a higher percentage of PDS patients required ICU admission, 9.4% vs 3.9% of patients (P=0.004). ICU admission indications did not vary between PDS and NACT patients. NACT patients admitted to the ICU had comparable mean surgical complexity scores to those PDS patients admitted to the ICU, 6.2 (95%CI 5.3-7.1) vs 4.5 (95%CI 3.1-6.0) (P=0.006). Length of ICU admission did not vary between groups, PDS 2.7days (95%CI 2.3-3.2) vs 3.5days (95%CI 1.5-5.6) for NACT (P=0.936). CONCLUSIONS: The rate of ICU admissions among patients undergoing PDS is higher than for NACT. Among patients admitted to the ICU, indications for admission, length of stay and surgical complexity were similar between patients treated with NACT and PDS.
OBJECTIVE: Admissions to intensive care units (ICU) are costly, but are necessary for some patients undergoing radical cancer surgery. When compared to primary debulking surgery (PDS), neoadjuvant chemotherapy (NACT) with interval debulking surgery, is associated with less peri-operative morbidity. In this study, we compare rates, indications and lengths of ICU stays among ovarian cancerpatients admitted to the ICU within 30days of cytoreduction, either primary or interval. METHODS: A retrospective chart review was performed of patients with stage III-IV ovarian cancer who underwent surgical cytoreduction at two large academic medical centers between 2010 and 2014. Chi square tests, Student t-tests, and Mann-U Whitney tests were used. RESULTS: A total of 635 patients were included in the study. There were 43 ICU admissions, 7% of patients. Compared to NACT, a higher percentage of PDSpatients required ICU admission, 9.4% vs 3.9% of patients (P=0.004). ICU admission indications did not vary between PDS and NACTpatients. NACTpatients admitted to the ICU had comparable mean surgical complexity scores to those PDSpatients admitted to the ICU, 6.2 (95%CI 5.3-7.1) vs 4.5 (95%CI 3.1-6.0) (P=0.006). Length of ICU admission did not vary between groups, PDS 2.7days (95%CI 2.3-3.2) vs 3.5days (95%CI 1.5-5.6) for NACT (P=0.936). CONCLUSIONS: The rate of ICU admissions among patients undergoing PDS is higher than for NACT. Among patients admitted to the ICU, indications for admission, length of stay and surgical complexity were similar between patients treated with NACT and PDS.
Authors: Joseph A Dottino; Weiguo He; Charlotte C Sun; Hui Zhao; Shuangshuang Fu; Jose Alejandro Rauh-Hain; Rudy S Suidan; Karen H Lu; Sharon H Giordano; Larissa A Meyer Journal: Int J Gynecol Cancer Date: 2020-07-02 Impact factor: 3.437
Authors: Christopher G Smith; Daniel L Davenport; Justin Gorski; Anthony McDowell; Brian T Burgess; Tricia I Fredericks; Lauren A Baldwin; Rachel W Miller; Christopher P DeSimone; Charles S Dietrich; Holly H Gallion; Edward J Pavlik; John R van Nagell; Frederick R Ueland Journal: Healthcare (Basel) Date: 2019-07-03
Authors: Alexandros Laios; Raissa Vanessa De Oliveira Silva; Daniel Lucas Dantas De Freitas; Yong Sheng Tan; Gwendolyn Saalmink; Albina Zubayraeva; Racheal Johnson; Angelika Kaufmann; Mohammed Otify; Richard Hutson; Amudha Thangavelu; Tim Broadhead; David Nugent; Georgios Theophilou; Kassio Michell Gomes de Lima; Diederick De Jong Journal: J Clin Med Date: 2021-12-24 Impact factor: 4.241