Postoperative adverse events (AEs) can delay chemotherapy but do not affect survival outcomes in patients with platinum-sensitive, recurrent ovarian cancer, according to a study published in Gynecologic Oncology.
The study showed that patients who had grade 3 or higher AEs after secondary cytoreductive surgery (SCS), with or without hyperthermic intraperitoneal chemotherapy (HIPEC), had a “slight delay” in receiving standard postoperative chemotherapy. However, these patients had similar progression-free survival (PFS) and overall survival (OS) outcomes as patients with grade 1-2 AEs.
The researchers evaluated AEs occurring within 30 days of surgery among 83 patients with platinum-sensitive ovarian cancer. The patients had undergone SCS, with or without HIPEC, as part of a phase 2 trial (ClinicalTrials.gov Identifier: NCT01767675).
A total of 50 had grade 1-2 postoperative AEs, and 33 had grade 3 or higher postoperative AEs. The most common grade 3 or higher AEs were anemia (27.7%) and abdominal infection (6%). Grade 3 or higher AEs were similar between patients who received HIPEC and those who did not.
The rate of complete gross resection was similar between patients who had grade 1-2 AEs (90%) and those who had grade 3 or higher AEs (85%; P =.51). However, length of hospital stay, operative time, estimated blood loss, urgent care visits, readmissions, reoperations, and interventional radiology procedures within 30 days of surgery were all significantly greater in the grade 3 or higher AE group (P <.001 for all).
The median time to initiation of postoperative chemotherapy was 34 days for patients with grade 3 or higher AEs and 31 days for patients with grade 1-2 AEs (P =.017). The researchers described this time difference as “likely not clinically meaningful.”
The median PFS was 11.2 months for patients with grade 3 or higher AEs and 14.9 months for patients with grade 1-2 AEs (P =.186). A multivariable analysis showed no significant difference in PFS between the groups (P =.56).
The median OS was 46.9 months for patients with grade 3 or higher AEs and 68.2 months for patients with grade 1-2 AEs (P =.053). A multivariable analysis showed no significant difference in OS between the groups (P =.066).
“Postoperative complications following SCS with or without HIPEC were associated with slight delays in chemotherapy initiation but did not significantly impact oncologic outcomes,” the researchers concluded. “Our results can help inform patients about the risks of adverse events associated with SCS.”
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Praiss AM, Zhou Q, Iasonos A, et al. Morbidity after secondary cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for ovarian cancer: An analysis of a randomized phase II trial.Gynecol Oncol. 2023;171:23-30. doi:10.1016/j.ygyno.2023.02.003