Impact of Sepsis on the Oncologic Outcomes of Advanced Epithelial Ovarian Cancer Patients: A Multicenter Observational Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Methods
2.1. Study Population
- To be diagnosed with a histologically confirmed EOC;
- To have FIGO stage IIB or higher (i.e., advanced-stage EOC);
- To be admitted to the ICU;
- To have an abdominal focus for their sepsis.
2.2. Definitions
2.3. Data Collection
2.4. Oncologic Outcomes
2.5. Statistical Analysis
2.6. Ethical Approval
3. Results
3.1. Study Population
3.2. Patient and Tumor Characteristics
3.3. Sepsis Characteristics
3.4. Oncologic Outcomes
3.5. Survival Outcomes
3.6. Sensitivity Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Sepsis Cohort (N = 18) | NCR Cohort (N = 3988) | Propensity-Matched NCR Cohort a (N = 54) |
---|---|---|---|
Number of Patients (IQR) or (%) | Number of Patients (IQR) or (%) | Number of Patients (IQR) or (%) | |
Age at diagnosis (in years) | |||
Median | 65 (60–73) | 65 (20–88) | 63 (43–79) |
FIGO stage | |||
Stage IIIC | 13 (72) | 2884 (72) | 38 (70) |
Stage IV | 5 (28) | 1104 (28) | 16 (30) |
Histologic subtype | |||
Serous | 16 (89) | 3211 (80) | 46 (85) |
Mucinous | 0 (0) | 72 (2) | 0 (0) |
Endometrioid | 0 (0) | 124 (3) | 5 (9) |
Clear cell | 0 (0) | 104 (3) | 0 (0) |
Adenocarcinoma NOS | 2 (11) | 428 (11) | 2 (6) |
Other | 0 (0) | 49 (1) | 0 (0) |
Treatment approach | |||
PCS | 4 (22) | 1144 (29) | 16 (30) |
NACT-ICS | 14 (78) | 2844 (71) | 38 (70) |
Bowel surgery | |||
No | 5 (28) | 3075 (77) | 13 (26) |
Yes | 13 (72) | 851 (21) | 40 (74) |
Unknown | 0 (0) | 62 (2) | 0 (0) |
Residual disease after debulking | |||
0 cm | 12 (67) | 1939 (49) | 38 (70) |
≤1 cm | 6 (33) | 1487 (37) | 14 (26) |
>1 cm | 0 (0) | 500 (12) | 2 (4) |
Unknown | 0 (0) | 62 (2) | 0 (0) |
Chemotherapy (primary treatment) | |||
Yes, adjuvant | 4 (22) | 1144 (29) | 16 (30) |
Yes, neoadjuvant and adjuvant | 9 (50) | 2725 (68) | 37 (68) |
Yes, neoadjuvant only | 5 (28) | 119 (3) | 1 (2) |
Characteristic | Number of Patients | (IQR) or % |
---|---|---|
Sepsis diagnosed during | ||
Primary EOC treatment | 16 | 89% |
Recurrent EOC treatment | 2 | 11% |
Time between surgery and sepsis onset (days) | ||
Median | 7 | (5–9) |
Severity of sepsis | ||
Non-vasopressor-dependent sepsis | 13 | 72% |
Vasopressor-dependent sepsis | 5 | 28% |
Site of infection | ||
Bowel complications | 13 | 72% |
Gastric perforation | 1 | 5.5% |
Pancreatic fluid leakage | 1 | 5.5% |
Urosepsis | 1 | 5.5% |
Vaginal cuff abscess | 1 | 5.5% |
Unclear | 1 | 5.5% |
Source control | ||
Abscess drainage | 3 | 17% |
Laparotomy including abscess drainage | 13 | 72% |
Insertion nephrostomy catheter | 1 | 5.5% |
Mechanical ventilation | 1 | 5.5% |
Antibiotic treatment duration (days) | ||
Median | 10 | (6–10) |
ICU length of stay | ||
Median | 3 | (1–8) |
Hospital length of stay | ||
Median | 24 | (18–42) |
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Said, S.A.; de Hullu, J.A.; van der Aa, M.A.; Walraven, J.E.W.; Bekkers, R.L.M.; Slangen, B.F.M.; Pickkers, P.; van Altena, A.M. Impact of Sepsis on the Oncologic Outcomes of Advanced Epithelial Ovarian Cancer Patients: A Multicenter Observational Study. Cancers 2023, 15, 4642. https://doi.org/10.3390/cancers15184642
Said SA, de Hullu JA, van der Aa MA, Walraven JEW, Bekkers RLM, Slangen BFM, Pickkers P, van Altena AM. Impact of Sepsis on the Oncologic Outcomes of Advanced Epithelial Ovarian Cancer Patients: A Multicenter Observational Study. Cancers. 2023; 15(18):4642. https://doi.org/10.3390/cancers15184642
Chicago/Turabian StyleSaid, Sherin A., Joanne A. de Hullu, Maaike A. van der Aa, Janneke E. W. Walraven, Ruud L. M. Bekkers, Brigitte F. M. Slangen, Peter Pickkers, and Anne M. van Altena. 2023. "Impact of Sepsis on the Oncologic Outcomes of Advanced Epithelial Ovarian Cancer Patients: A Multicenter Observational Study" Cancers 15, no. 18: 4642. https://doi.org/10.3390/cancers15184642
APA StyleSaid, S. A., de Hullu, J. A., van der Aa, M. A., Walraven, J. E. W., Bekkers, R. L. M., Slangen, B. F. M., Pickkers, P., & van Altena, A. M. (2023). Impact of Sepsis on the Oncologic Outcomes of Advanced Epithelial Ovarian Cancer Patients: A Multicenter Observational Study. Cancers, 15(18), 4642. https://doi.org/10.3390/cancers15184642