Cornel Karlijn M C, Nguyen Julie My Van, Gien Lilian T, Covens Allan, Vicus Danielle
Division of Gynecologic Oncology, University of Toronto, Toronto, ON M5G 1E2, Canada.
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON L8S 4L8, Canada.
Curr Oncol. 2025 Aug 21;32(8):474. doi: 10.3390/curroncol32080474.
Surgical site infections (SSIs) occur in 10-15% of patients and are linked to up to 29% of delays in starting adjuvant treatment. This study assessed the association between SSIs in patients with ovarian and uterine cancer and their impact on time to adjuvant therapy and oncologic outcomes. Patients who underwent surgery from 1 January 2015 to 30 September 2017 were included, using institutional National Surgical Quality Improvement Program (NSQIP) data and chart reviews. Among 371 patients (median follow-up 4.1 years), 243 (65.5%) received adjuvant treatment. The median time to start was 39 days for chemotherapy, 61 days for radiotherapy, and 42 days for combined therapy ( < 0.001). Patients with ovarian cancer began treatment sooner than those with uterine cancer (39 vs. 52 days, < 0.001), but no significant difference was observed between those with or without SSIs. In 238 patients with uterine cancer, those with SSIs had a twofold higher recurrence risk (HR 1.97, = 0.022) and over threefold lower overall survival (HR 3.45, = 0.018). Multivariable analysis showed that surgical route and disease stage were independent predictors; SSI was not an independent factor. No survival difference related to SSIs was found in patients with ovarian cancer. Further research is needed to clarify the impact of SSIs on treatment timing and recurrence.
手术部位感染（SSIs）发生在10%至15%的患者中，并且与高达29%的辅助治疗开始延迟有关。本研究评估了卵巢癌和子宫癌患者手术部位感染之间的关联及其对辅助治疗时间和肿瘤学结局的影响。使用机构国家外科质量改进计划（NSQIP）数据和病历审查，纳入了2015年1月1日至2017年9月30日接受手术的患者。在371例患者中（中位随访4.1年），243例（65.5%）接受了辅助治疗。化疗开始的中位时间为39天，放疗为61天，联合治疗为42天（<0.001）。卵巢癌患者比子宫癌患者开始治疗更早（39天对52天，<0.001），但有或无手术部位感染的患者之间未观察到显著差异。在238例子宫癌患者中，有手术部位感染的患者复发风险高出两倍（风险比1.97，P = 0.022），总生存率低三倍多（风险比3.45，P = 0.018）。多变量分析显示手术途径和疾病分期是独立预测因素；手术部位感染不是独立因素。在卵巢癌患者中未发现与手术部位感染相关的生存差异。需要进一步研究以阐明手术部位感染对治疗时机和复发的影响。
