Days alive and out of hospital after surgical treatment of epithelial ovarian cancer: A Danish nationwide cohort study
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Days alive and out of hospital after surgical treatment of epithelial ovarian cancer : A Danish nationwide cohort study. / Ekmann-Gade, Anne Weng; Høgdall, Claus; Seibæk, Lene; Noer, Mette Calundann; Rasmussen, Annette; Schnack, Tine Henrichsen.
In: European Journal of Surgical Oncology, Vol. 49, No. 10, 107039, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Days alive and out of hospital after surgical treatment of epithelial ovarian cancer
T2 - A Danish nationwide cohort study
AU - Ekmann-Gade, Anne Weng
AU - Høgdall, Claus
AU - Seibæk, Lene
AU - Noer, Mette Calundann
AU - Rasmussen, Annette
AU - Schnack, Tine Henrichsen
N1 - Publisher Copyright: © 2023 The Authors
PY - 2023
Y1 - 2023
N2 - Objective: Days alive and out of hospital (DAOH) is a validated outcome measure in perioperative trials integrating information on primary hospitalization, readmissions, and mortality. It is negatively associated with advanced age. However, DAOH has not been described for surgical treatment of epithelial ovarian cancer (EOC), primarily diagnosed in older patients. Methods: We conducted a Danish nationwide cohort study including patients undergoing debulking surgery for EOC from 2013 to 2018. DAOH was explored for 30 (DAOH30), 90 (DAOH90), and 180 (DAOH180) postoperative days in younger (<70 years) and older (≥70 years) patients with advanced-stage disease stratified by surgical modality (primary (PDS) or interval debulking surgery (IDS)). We examined the associations between patient- and surgical outcomes and low or high DAOH30. Results: Overall, 1168 patients had stage IIIC-IV disease and underwent debulking surgery. DAOH30 was 22 days [interquartile range (IQR): 18, 25] and 23 days [IQR: 18, 25] for younger and older patients treated with PDS, respectively. For IDS, DAOH30 was 25 days [IQR: 22, 26] for younger and 25 days[IQR: 21, 26] for older patients. We found no significant differences between age cohorts regarding DAOH30, DAOH90, and DAOH180. Low DAOH30 was associated with poor performance status, PDS, extensive surgery, and long duration of surgery in adjusted analysis. Conclusions: DAOH did not differ significantly between age cohorts. Surgical rather than patient-related factors were associated with low DAOH30. Our results likely reflect a high selection of fit older patients for surgery, reducing the patient-related differences between younger and older patients receiving surgical treatment.
AB - Objective: Days alive and out of hospital (DAOH) is a validated outcome measure in perioperative trials integrating information on primary hospitalization, readmissions, and mortality. It is negatively associated with advanced age. However, DAOH has not been described for surgical treatment of epithelial ovarian cancer (EOC), primarily diagnosed in older patients. Methods: We conducted a Danish nationwide cohort study including patients undergoing debulking surgery for EOC from 2013 to 2018. DAOH was explored for 30 (DAOH30), 90 (DAOH90), and 180 (DAOH180) postoperative days in younger (<70 years) and older (≥70 years) patients with advanced-stage disease stratified by surgical modality (primary (PDS) or interval debulking surgery (IDS)). We examined the associations between patient- and surgical outcomes and low or high DAOH30. Results: Overall, 1168 patients had stage IIIC-IV disease and underwent debulking surgery. DAOH30 was 22 days [interquartile range (IQR): 18, 25] and 23 days [IQR: 18, 25] for younger and older patients treated with PDS, respectively. For IDS, DAOH30 was 25 days [IQR: 22, 26] for younger and 25 days[IQR: 21, 26] for older patients. We found no significant differences between age cohorts regarding DAOH30, DAOH90, and DAOH180. Low DAOH30 was associated with poor performance status, PDS, extensive surgery, and long duration of surgery in adjusted analysis. Conclusions: DAOH did not differ significantly between age cohorts. Surgical rather than patient-related factors were associated with low DAOH30. Our results likely reflect a high selection of fit older patients for surgery, reducing the patient-related differences between younger and older patients receiving surgical treatment.
KW - Aged
KW - Cytoreduction surgical procedures
KW - Length of stay
KW - Mortality
KW - Ovarian epithelial carcinoma
KW - Patient readmission
U2 - 10.1016/j.ejso.2023.107039
DO - 10.1016/j.ejso.2023.107039
M3 - Journal article
C2 - 37639861
AN - SCOPUS:85169053723
VL - 49
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
SN - 0748-7983
IS - 10
M1 - 107039
ER -
ID: 396014982