AI Article Synopsis

  • - The study aimed to determine if intraoperative rupture during surgeries for early-stage epithelial ovarian cancer affects patient outcomes, specifically focusing on progression-free survival (PFS).
  • - Researchers analyzed data from 338 patients (197 unruptured and 141 ruptured) and found no significant difference in 5-year PFS before matching but a concerning trend after adjusting for other factors, particularly in patients with aggressive tumor types.
  • - The conclusions suggest that while the effect of rupture on PFS wasn’t statistically significant, it could still have negative implications for treatment and outcomes, emphasizing the importance of preventing rupture during surgery.

Article Abstract

Objective: To evaluate whether intraoperative rupture affects oncological outcomes in patients with early-stage epithelial ovarian cancer (EOC).

Methods: A multicenter retrospective study was conducted on patients with early-stage EOC based on surgical and final pathological reports between 2007 and 2021. Oncologic outcomes were compared between the unruptured group (International Federation of Gynaecology and Obstetrics [FIGO] stage IA/IB) and ruptured group (FIGO stage IC1). The primary endpoint was progression-free survival (PFS). Propensity score matching (PSM) was performed to adjust for the imbalance in prognostic factors between the groups.

Results: Overall, 197 (58.3 %) patients comprised the unruptured group (FIGO stage IA/IB), and 141 (41.7 %) were in the intraoperatively ruptured group (FIGO stage IC1). No significant difference in the 5-year PFS was observed between the two groups before PSM (92.65 % vs. 92.80 %, P = 0.93). After PSM, the 5-year PFS showed a noticeable decrease in the ruptured group compared to the unruptured group, although this difference showed borderline statistical significance (96.90 % vs. 89.82 %, P = 0.061). This trend was particularly discernible in cases with aggressive tumor characteristics; intraoperative rupture remained an independent prognostic factor for shorter PFS in patients with high-grade histology (adjusted hazard ratio = 14.4, 95 % confidence interval = 2.8-74.1).

Conclusions: Although not statistically significant, intraoperative rupture may negatively affect PFS in these patients after PSM. Therefore, rupture during surgery should be avoided as it can cause upstaging and unnecessary chemotherapy.

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Source
http://dx.doi.org/10.1016/j.ejso.2024.108515DOI Listing

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