Design: Prospective multicentre observational study
Setting: United Kingdom, Kolkata, India, and Melbourne, Australia gynaecological cancer surgery centres.
Participants: Patients undergoing surgical resection for late stage ovarian cancer.
Exposure: Low, intermediate or high Surgical Complexity Score (SCS) surgery
Main outcomes and measures: Primary: EORTC-QLQ-C30 Global score change. Secondary: EORTC OV28, progression free survival.
Results: Patients’ pre-operative disease burden and SCS varied between centres, confirming differences in surgical ethos. QoL response rates were 90% up to 18 months. Mean change from the pre-surgical baseline in the EORTC QLQ-C30 was 3.4 (SD 1.8, n=88) in the low, 4.0 (SD 2.1, n=55) in the intermediate and 4.3 (SD 2.1, n=52) in the high SCS group after 6 weeks (p=0.048) and 4.3 (SD 2.1, n=51), 5.1 (SD 2.2, n=41) and 5.1 (SD 2.2, n=35) respectively after 12 months (p=0.133). In a repeated measures model, there were no clinically or statistically meaningful differences in EORTC QLQ-C30 global scores between the three SCS groups, p= 0.840 but there was a small statistically significant improvement in all groups over time (p<0.001). The high SCS group experienced small to moderate decreases in physical (p=0.004), role (p=0.016) and emotional (p=0.001) function at 6 weeks post-surgery which resolved by 6-12 months.
Conclusions and relevance: Global QoL of patients undergoing low, intermediate, and high SCS surgery improved at 12 months post operation and was no worse in patients undergoing extensive surgery.
Extensive surgery compared to lower complexity surgery does not result in poorer quality of life in patients with advanced ovarian cancer.
|Journal||BJOG: An International Journal of Obstetrics & Gynaecology|
|Early online date||5 Dec 2021|
|Publication status||E-pub ahead of print - 5 Dec 2021|