{
    "abstract": "To independently validate a published risk-calculator for adverse perioperative outcomes in patients with epithelial ovarian cancer undergoing debulking surgery at a high-volume surgical center.\nUsing our institution's curated prospective ovarian cancer database, we identified patients with epithelial ovarian cancer who underwent a debulking procedure from 7/2015 to 5/2019, to be used as the validation cohort. Variables used in the published nomogram were collected. These included American Society of Anesthesiology classification, preoperative albumin, history of bleeding disorder, presence of ascites on preoperative imaging, designation of elective or emergent surgery, age of the patient, and a procedure score. Patients were included if they had information available for all the variables used in the nomogram, and 30-day follow-up within our institution. The primary outcome was Clavien-Dindo Class IV with specific conditions (postoperative sepsis, septic shock, cardiac arrest, myocardial infarction, pulmonary embolism, ventilation >48\u00a0h, or unplanned intubation) and 30-day mortality. The combination of these endpoints is called the combined complication rate.\nA total of 700 patients who underwent debulking surgery for epithelial ovarian cancer during the timeframe met inclusion criteria. The combined complication rate was 11.7%; 9.9% of patients were readmitted; 2.7% required reoperation. Sepsis was the most common primary endpoint complication (4.4%), followed by septic shock (1.4%). There was no 30-day mortality in our cohort. The nomogram performed well, with a c index of 0.715 (95% CI 0.66-0.768), which was comparable to the published nomogram.\nWe independently validated a complication nomogram at a high-volume surgical center. This nomogram performs well at predicting a lower likelihood of serious postoperative complications. An enhanced nomogram would help identify patients at higher risk for serious complications.",
    "authors": [
        {
            "affiliation": "Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.",
            "firstname": "Alli M",
            "initials": "AM",
            "lastname": "Straubhar"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, University of Cincinnati Medical Center, Cincinnati, OH, United States of America.",
            "firstname": "Jennifer L",
            "initials": "JL",
            "lastname": "Wolf"
        },
        {
            "affiliation": "Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, United States of America.",
            "firstname": "Ms Qin C",
            "initials": "MQC",
            "lastname": "Zhou"
        },
        {
            "affiliation": "Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, United States of America.",
            "firstname": "Alexia",
            "initials": "A",
            "lastname": "Iasonos"
        },
        {
            "affiliation": "Brigham and Women's Hospital, Boston, MA, United States of America.",
            "firstname": "Stephanie",
            "initials": "S",
            "lastname": "Cham"
        },
        {
            "affiliation": "Columbia University College of Physicians and Surgeons, New York, NY, United States of America.",
            "firstname": "Jason D",
            "initials": "JD",
            "lastname": "Wright"
        },
        {
            "affiliation": "Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America; Weill Medical College of Cornell University, New York, NY, United States of America.",
            "firstname": "Kara",
            "initials": "K",
            "lastname": "Long Roche"
        },
        {
            "affiliation": "Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America; Weill Medical College of Cornell University, New York, NY, United States of America.",
            "firstname": "Dennis S",
            "initials": "DS",
            "lastname": "Chi"
        },
        {
            "affiliation": "Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America; Weill Medical College of Cornell University, New York, NY, United States of America. Electronic address: zivanovo@mskcc.org.",
            "firstname": "Oliver",
            "initials": "O",
            "lastname": "Zivanovic"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2020 Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.ygyno.2020.11.021\n10.1016/j.ygyno.2017.02.023\n10.1016/j.ygyno.2010.05.031\n10.1200/JCO.2014.56.3106\n10.1016/j.ejca.2009.10.017\n10.1016/j.ygyno.2016.11.022\n10.1097/IGC.0000000000000339\n10.1016/j.ygyno.2015.10.025\n10.1245/s10434-015-4938-9\n10.1016/j.ygyno.2012.04.014\n10.1016/j.ajog.2019.02.019\n10.1097/00000658-199810000-00006\n10.1016/j.ygyno.2010.09.010\n10.1016/j.ygyno.2020.05.041\n10.1016/j.ygyno.2014.07.002\n10.1016/j.ygyno.2017.02.020\n10.1097/01.sla.0000133083.54934.ae\n10.1200/JCO.2007.12.9791\n10.1016/j.ygyno.2015.03.043\n10.1016/j.ygyno.2015.04.037\n10.1016/j.ygyno.2020.06.101\n10.1006/gyno.2002.6748\n10.1016/j.ygyno.2015.11.030\n10.1002/cncr.32447\n10.1016/j.ajog.2007.10.495\n10.1016/j.ygyno.2013.08.011\n10.1016/j.ygyno.2014.07.103\n10.1016/j.ygyno.2019.08.004\n10.1016/j.ygyno.2017.07.010",
    "journal": "Gynecologic oncology",
    "keywords": [
        "Cytoreduction",
        "Ovarian cancer",
        "Perioperative complications",
        "Surgical procedures"
    ],
    "methods": null,
    "publication_date": "2020-12-05",
    "pubmed_id": "33272645\n28238354\n20609464\n25667285\n19900801\n27908531\n25611896\n26541980\n26511267\n22507533\n30771346\n9790339\n20933255\n32518012\n25019568\n28209497\n15273542\n18323559\n25824857\n25976399\n12144829\n26631607\n31454432\n18060979\n23962700\n25110330\n31402165\n28734498",
    "results": "A total of 700 patients who underwent debulking surgery for epithelial ovarian cancer during the timeframe met inclusion criteria. The combined complication rate was 11.7%; 9.9% of patients were readmitted; 2.7% required reoperation. Sepsis was the most common primary endpoint complication (4.4%), followed by septic shock (1.4%). There was no 30-day mortality in our cohort. The nomogram performed well, with a c index of 0.715 (95% CI 0.66-0.768), which was comparable to the published nomogram.",
    "title": "Advanced ovarian cancer and cytoreductive surgery: Independent validation of a risk-calculator for perioperative adverse events.",
    "xml": "<Element 'PubmedArticle' at 0x788503f0f6a0>"
}