237 Selected global health assessment tools significantly predict postoperative clinical outcome in elderly patients with ovarian cancer

• Published in: International journal of gynecological cancer Vol. 31; no. Suppl 3; p. A213
• Main Authors: Anic, K, Flohr, F, Schmidt, MW, Krajnak, S, Linz, V, Schwab, R, Westphalen, C, Hartmann, EK, Schmidt, M, Hasenburg, A, Battista, M
• Format: Journal Article
• Language: English
• Published: Oxford BMJ Publishing Group Ltd 12.10.2021; BMJ Publishing Group LTD
• Subjects: Clinical outcomes; Frailty; Ovarian cancer
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1136/ijgc-2021-ESGO.364

Introduction/Background*This study evaluated the impact of the global health status on the rate of postoperative clinical complications in patients with ovarian cancer (OC) older than 60 years.MethodologySelected global health status assessment tools were retrospectively determined in a cohort of OC patients older than 60 years, treated at our institution between 2008 and 2019. The primary outcome was the incidence and type of postoperative clinical complications in accordance with the Veteran Affairs’ National Surgical Quality Improvement Program (NSQIP). Differences in binary and ordinal variables between independent groups were analyzed by the chi-square test. Furthermore, rank correlations were examined with Spearman-Correlation.Result(s)*116 patients entered the study. 54 patients (46.6%) were classified as G-8 frail and 56 patients (48.3%) as G-8 non-frail. CCI classified 24 patients (20.7%) into CCI-1, 63 patients (54.3%) into CCI-2 and 29 patients (25.0%) into CCI-3. The ASA PS allocated 48 patients (44.0%) as ASA-2 and 61 patients (56.0%) as ASA-3. The Lee-Index allocated 60 patients (61.9%) to a cohort with a four-year-mortality <20% and 37 patients (38.1%) with a higher mortality. Two patients died within 60 days after surgery in the G-8 frail group and the CCI-2 cohort. In total, 23 patients (19.8%) suffered from perioperative therapy relevant clinical complications (e.g. cardiopulmonary (11.8%) or multiorgan complications (6.9%)). The total rates of relevant postoperative clinical complications were significantly higher in the group of G-8 frail patients (13.6% vs. 6.4%; p=0.045) and the CCI-2 and CCI-3 groups (CCI-2: 12.1%, CCI-3: 6.9% vs. CCI-1: 0.9%; p=0.081). ASA PS, Lee-Index and age alone were not able to predict the clinical complications. Furthermore, G-8 frail and CCI-frail status were significantly associated with an administration of more perioperative transfusions (G-8: 32.7% vs. 15.3%; p=0.031 and CCI-2 + CCI-3: 31.5% + 16.2% vs. 3.6%; p=0.002). Neither global health status nor age showed an association with postoperative revisions or length of hospitalization.Conclusion*Preoperative evaluation of global health status with G-8 score and CCI were significantly associated with elevated rates of postoperative complications and the need of transfusions, in contrast to age alone in elderly patients with OC.