A radiologic-laparoscopic model to predict suboptimal (or complete and optimal) debulking surgery in advanced ovarian cancer: a pilot study

Introduction: Medical models assist clinicians in making diagnostic and prognostic decisions in complex situations. In advanced ovarian cancer, medical models could help prevent unnecessary exploratory surgery. We designed two models to predict suboptimal or complete and optimal cytoreductive surgery in patients with advanced ovarian cancer. Methods: We collected clinical, pathological, surgical, and residual tumor data from 110 patients with advanced ovarian cancer. Computed tomographic and laparoscopic data from these patients were used to determine peritoneal cancer index (PCI) and lesion size score. These data were then used to construct two-by-two contingency tables and our two predictive models. Each model included three risk score levels; the R4 model also included operative PCI, while the R3 model did not. Finally, we used the original patient data to validate the models (narrow validation). Results: Our models predicted suboptimal or complete and optimal cytoreductive surgery with a sensitivity of 83% (R4 model) and 69% (R3 model). Our results also showed that PCI>20 was a major risk factor for unresectability. Conclusion: Our medical models successfully predicted suboptimal or complete and optimal cytoreductive surgery in 110 patients with advanced ovarian cancer. Our models are easy to construct, based on readily available laboratory test data, simple to use clinically, and could reduce unnecessary exploratory surgery in this patient group

Predictive model for major complications after extensive abdominal surgery in primary advanced ovarian cancer

Background Surgery for advanced ovarian cancer (AOC) frequently results in serious complications. The present study aimed to determine the importance of various factors and complications in cytoreductive surgery for AOC. Patients and methods The present study included 90 patients with AOC who underwent primary cytoreductive surgery in a single institution from January 2013 to August 2017. Demographic and clinicopathologic characteristics, surgical procedures, residual disease, and follow-up data were analyzed. Cytoreductive surgery was defined as complete (no residual tumor), optimal (residual tumor 1 cm in diameter). Grade III–IV complications were considered major. Patients were evaluated every 3–6 months. Results Surgical outcome was complete in 75 (82%), optimal in 5 (6%), and suboptimal in 11 (12%) patients. Major complications occurred in 28 (31%) patients. Independent risk factors for major complications were ≥five visceral resections, rectosigmoid resection, glissectomy, and pelvic peritonectomy. A score created by weighing the multivariate OR for each risk factor correctly predicted major complications in 67% of cases. A score cut-off of >2 discriminated between patients with and without complications in 79% of cases (95% CI: 70%–86%, P<0.001). Adjuvant chemotherapy was performed as planned in 67 patients (74%), including 50 (75%) without major complications and 17 (25%) with major complications. Conclusion Risk factors for major complications in cytoreductive surgery for AOC are ≥five visceral resections, rectosigmoid resection, glissectomy, and pelvic peritonectomy. Our model predicts morbidity based on major and minor classifications of complications

LA U INVESTIGA: Revista Científica. Facultad Ciencias de la Salud. Volumen 1.

La U Investiga: Revista Científica. Facultad de Ciencias de la Salud. Volumen 1.Seguridad e inocuidad del implante subdermico de etonogestrel 68mg en pacientes que cursan el puerperio inmediato. Estudio analítico de embarazadas adolescentes atendidas en el servicio de ginecología del Hospital San Vicente de Paúl. Disfuncionalidad de la red de Salud para la atención materna en Quiroga – Imbabura – Ecuador. Diagnóstico de la medicina tradicional indígena en la Provincia de Napo – Ecuador. Prevalencia del síndrome de burnout en fisioterapeutas de la Provincia de Imbabura. Evaluación de factores de riesgo de enfermedades crónicas no transmisibles en la población de la comunidad de Carpuela – Imbabura. Situación laboral de los egresados de enfermería de la Universidad Técnica del Norte, Ibarra – Ecuador. Comparación del uso de la harina de semilla de amaranto y otros tipos de harina en la elaboración de panes tradicionales del Ecuador. Resultados del programa Ecuador Ejercítate en mujeres adultas de la ciudad de Otavalo