Benyahia Steven, Avila Monica, Coughlin Emily, Mahil Amreesh, Riveron Alejandra, Luo Yi, Wenham Robert, Huang Jeffrey
Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Department of Gynecological Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Cancer Control. 2025 Jan-Dec;32:10732748251339248. doi: 10.1177/10732748251339248. Epub 2025 Apr 28.
IntroductionOvarian cancer remains a leading cause of gynecologic cancer-related mortality worldwide. Identifying perioperative factors that influence survival outcomes is essential for optimizing care. This study evaluates the impact of perioperative factors such as intraoperative blood transfusions and hospital length of stay (LOS) on survival rates in ovarian cancer patients undergoing surgical debulking.MethodsThis retrospective study analyzed charts of 314 patients who underwent ovarian cancer surgery at a single institution between 2010 and 2018. Patients were grouped based on survival status: "Live" or "Death". Variables included demographics, tumor size, comorbidity, anesthesia time, surgery time, estimated blood loss, transfusion, readmission, hospital stay length, and survival. Statistical analyses included log-rank tests and mean survival estimations: chi-square tests and Mann-Whitney U-test. Significance was set at < .05.ResultsThe mean follow-up was 50.5 months (95% CI, 47.8-53.2). Prolonged LOS (>3 days) was significantly associated with reduced survival (47.4 vs 52.4 months, = .015). Patients requiring intraoperative blood transfusions had poorer survival outcomes (42.0 months 95% CI, 36.3-47.7 vs 53.1 months 95% CI, 50.3-55.9, < .001). The "Death" group experienced greater blood loss, longer surgical/anesthesia times, and higher intraoperative fluid requirements.ConclusionProlonged hospital stays and intraoperative blood transfusions are associated with worse survival outcomes in ovarian cancer patients undergoing surgery. These findings underscore the importance of perioperative optimization strategies, including minimizing transfusion requirements and reducing LOS through enhanced recovery protocols.
引言
卵巢癌仍然是全球妇科癌症相关死亡的主要原因。确定影响生存结果的围手术期因素对于优化治疗至关重要。本研究评估了围手术期因素,如术中输血和住院时间(LOS)对接受手术减瘤的卵巢癌患者生存率的影响。
方法
这项回顾性研究分析了2010年至2018年在一家机构接受卵巢癌手术的314例患者的病历。患者根据生存状态分组:“存活”或“死亡”。变量包括人口统计学、肿瘤大小、合并症、麻醉时间、手术时间、估计失血量、输血、再次入院、住院时间和生存情况。统计分析包括对数秩检验和平均生存估计:卡方检验和曼-惠特尼U检验。显著性设定为<0.05。
结果
平均随访时间为50.5个月(95%CI,47.8 - 53.2)。住院时间延长(>3天)与生存率降低显著相关(47.4对52.4个月,P = 0.015)。需要术中输血的患者生存结果较差(42.0个月95%CI,36.3 - 47.7对53.1个月95%CI,50.3 - 55.9,P < 0.001)。“死亡”组失血量更大、手术/麻醉时间更长且术中液体需求量更高。
结论
住院时间延长和术中输血与接受手术的卵巢癌患者较差的生存结果相关。这些发现强调了围手术期优化策略的重要性,包括尽量减少输血需求和通过强化康复方案缩短住院时间。