Baldwin Lauren A, Pavlik Edward J, Ueland Emma, Brown Hannah E, Ladd Kelsey M, Huang Bin, DeSimone Christopher P, van Nagell John R, Ueland Frederick R, Miller Rachel W
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center and the Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293, USA.
Diagnostics (Basel). 2017 Mar 8;7(1):16. doi: 10.3390/diagnostics7010016.
The aim of this study was to evaluate complications of surgical intervention for participants in the Kentucky Ovarian Cancer Screening Program and compare results to those of the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial. A retrospective database review included 657 patients who underwent surgery for a positive screen in the Kentucky Ovarian Cancer Screening Program from 1988-2014. Data were abstracted from operative reports, discharge summaries, and office notes for 406 patients. Another 142 patients with incomplete records were interviewed by phone. Complete information was available for 548 patients. Complications were graded using the Clavien-Dindo (C-D) Classification of Surgical Complications and considered minor if assigned Grade I (any deviation from normal course, minor medications) or Grade II (other pharmacological treatment, blood transfusion). C-D Grade III complications (those requiring surgical, endoscopic, or radiologic intervention) and C-D Grade IV complications (those which are life threatening) were considered "major". Statistical analysis was performed using SAS 9.4 software. Complications were documented in 54/548 (10%) subjects. For women with malignancy, 17/90 (19%) had complications compared to 37/458 (8%) with benign pathology ( < 0.003). For non-cancer surgery, obesity was associated with increased complications ( = 0.0028). Fifty patients had minor complications classified as C-D Grade II or less. Three of 4 patients with Grade IV complications had malignancy ( < 0.0004). In the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial, 212 women had surgery for ovarian malignancy, and 95 had at least one complication (45%). Of the 1080 women with non-cancer surgery, 163 had at least one complication (15%). Compared to the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial, the Kentucky Ovarian Cancer Screening Program had significantly fewer complications from both cancer and non-cancer surgery ( < 0.0001 and = 0.002, respectively). Complications resulting from surgery performed as a result of the Kentucky Ovarian Cancer Screening Program were infrequent and significantly fewer than reported in the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial. Complications were mostly minor (93%) and were more common in cancer versus non-cancer surgery.
本研究旨在评估肯塔基州卵巢癌筛查项目参与者手术干预的并发症，并将结果与前列腺、肺、结肠直肠癌和卵巢癌筛查试验的结果进行比较。一项回顾性数据库审查纳入了1988年至2014年期间在肯塔基州卵巢癌筛查项目中因筛查呈阳性而接受手术的657例患者。从406例患者的手术报告、出院小结和门诊记录中提取数据。另外142例记录不完整的患者通过电话进行了访谈。548例患者获得了完整信息。并发症采用Clavien-Dindo（C-D）手术并发症分类法进行分级，如果分级为I级（任何偏离正常病程、使用小剂量药物）或II级（其他药物治疗、输血）则视为轻微并发症。C-D III级并发症（需要手术、内镜或放射学干预的并发症）和C-D IV级并发症（危及生命的并发症）被视为“严重”并发症。使用SAS 9.4软件进行统计分析。548例受试者中有54例（10%）记录了并发症。对于患有恶性肿瘤的女性，90例中有17例（19%）出现并发症；而良性病变的458例中有37例（8%）出现并发症（P<0.003）。对于非癌症手术，肥胖与并发症增加相关（P=0.0028）。50例患者出现分类为C-D II级或更低级别的轻微并发症。4例IV级并发症患者中有3例患有恶性肿瘤（P<0.0004）。在前列腺、肺、结肠直肠癌和卵巢癌筛查试验中，212例女性因卵巢恶性肿瘤接受手术，95例至少出现一种并发症（45%）。在1080例接受非癌症手术的女性中，163例至少出现一种并发症（15%）。与前列腺、肺、结肠直肠癌和卵巢癌筛查试验相比，肯塔基州卵巢癌筛查项目在癌症手术和非癌症手术中出现的并发症均显著更少（分别为P<0.0001和P=0.002）。肯塔基州卵巢癌筛查项目导致的手术并发症发生率较低，且显著低于前列腺、肺、结肠直肠癌和卵巢癌筛查试验报告的发生率。并发症大多为轻微并发症（93%），在癌症手术中比非癌症手术中更常见。
