Table 3.
Treatment intent, surgical details and postoperative outcomes of patients who underwent gynecologic cancer surgery (n=3784)
| Uterus (n=1751) | Ovary (n=1355) | Cervix (n=449) | Vulva/vagina (n=223) | Total (n=3784) | P value | |
|---|---|---|---|---|---|---|
| Treatment intenta | ||||||
| Curative | 1669 (95.3) | 1095 (80.8) | 426 (94.8) | 204 (91.5) | 3400 (89.9) | .977 |
| Life-prolonging | 79 (4.5) | 258 (19.0) | 23 (5.1) | 19 (8.5) | 379 (10.0) | |
| Palliative | 2 (0.1) | 2 (0.2) | 0 (0) | 0 (0) | 4 (0.1) | |
| Not available | 1 (0.1) | 0 (0) | 0 (0) | 0 (0) | 1 (<0.1) | |
| Neoadjuvant therapy | ||||||
| Chemotherapy | 29 (1.7) | 279 (20.6) | 15 (3.3) | 5 (2.2) | 328 (8.7) | <.0001 |
| Radiotherapy | 19 (1.1) | 1 (0.1) | 2 (0.5) | 3 (1.4) | 25 (0.7) | .008 |
| Hormonal therapy | 14 (0.8) | 2 (0.1) | 0 (0) | 0 (0) | 16 (0.4) | .024 |
| Targeted therapy | 0 (0) | 4 (0.3) | 0 (0) | 0 (0) | 4 (0.1) | .127 |
| Other | 0 (0) | 1 (0.1) | 0 (0) | 0 (0) | 1 (<0.1) | .774 |
| Time to operation | 3 (1–5) | 3 (1–5) | 3 (1–5) | 3 (2–5) | 3 (1–5) | <.0001 |
| ≤8 wk | 1605 (91.7) | 1142 (84.3) | 405 (90.2) | 202 (90.6) | 3360 (88.8) | |
| >8 wk | 146 (8.3) | 213 (15.7) | 44 (9.8) | 21 (9.4) | 424 (11.2) | |
| Areas of surgical resectionb | ||||||
| Pelvis/Perineal | 1443 (82.4) | 616 (45.5) | 374 (83.3) | 189 (84.8) | 2624 (69.3) | <.0001 |
| Midabdominal | 122 (7.0) | 430 (31.7) | 6 (1.3) | 4 (1.8) | 562 (14.9) | |
| Upper-abdominal | 120 (6.9) | 171 (12.6) | 27 (6.0) | 1 (0.5) | 319 (8.4) | |
| Others | 66 (3.8) | 138 (10.2) | 42 (9.4) | 29 (13.0) | 279 (7.4) | |
| Bowel surgery | ||||||
| No | 1734 (99.0) | 1252 (92.4) | 439 (97.8) | 220 (98.7) | 3651 (96.5) | <.0001 |
| Yes | 17 (1.0) | 103 (7.6) | 10 (2.2) | 3 (1.4) | 133 (3.5) | |
| Approach | ||||||
| Open | 751 (42.9) | 1101 (81.3) | 292 (65.0) | 204 (91.5) | 2353 (62.2) | <.0001 |
| Minimally-invasive | 963 (55.0) | 211 (15.6) | 150 (33.4) | 17 (7.6) | 1342 (35.5) | |
| Converted | 37 (2.1) | 42 (3.1) | 5 (1.1) | 0 (0) | 84 (2.2) | |
| Not available | 0 (0) | 1 (0.1) | 2 (0.5) | 2 (0.9) | 5 (0.1) | |
| Postoperative stay (d) | 3 (1–5) | 5 (3–8) | 3 (1–5) | 3 (2–6) | 4 (2–6) | .0001 |
| 30-d surgical morbidity | ||||||
| Any complications | 274 (15.7) | 303 (22.4) | 88 (19.6) | 65 (29.2) | 731 (19.3) | <.0001 |
| Respiratory complications | 18 (1.0) | 32 (2.4) | 4 (0.9) | 4 (1.8) | 58 (1.5) | .030 |
| COVID-19 infection | 7 (0.4) | 14 (1.0) | 1 (0.2) | 0 (0) | 22 (0.6) | .087 |
| Wound infection | 67 (3.8) | 54 (4.0) | 20 (4.4) | 28 (12.6) | 169 (4.5) | |
| Hemorrhage | 44 (2.5) | 78 (5.8) | 7 (1.6) | 2 (0.9) | 131 (3.5) | <.0001 |
| Ileus | 25 (1.4) | 52 (3.8) | 12 (2.7) | 0 (0) | 89 (2.4) | <.0001 |
| Urinary tract infection | 25 (1.4) | 29 (2.1) | 18 (4.0) | 5 (2.2) | 77 (2.0) | <.0001 |
| Wound dehiscence | 30 (1.7) | 11 (0.8) | 5 (1.1) | 25 (11.2) | 71 (1.9) | .016 |
| Sepsis | 14 (0.8) | 16 (1.2) | 4 (0.9) | 3 (1.3) | 37 (1.0) | <.0001 |
| Thromboembolism | 12 (0.7) | 17 (1.3) | 0 (0) | 1 (0.4) | 30 (0.8) | .817 |
| Kidney Injury | 7 (0.4) | 17 (1.3) | 3 (0.7) | 1 (0.4) | 28 (0.7) | .095 |
| Other organ injury | 8 (0.5) | 10 (0.7) | 6 (1.3) | 1 (0.4) | 25 (0.7) | .092 |
| Anastomosis leak | 2 (0.1) | 4 (0.3) | 1 (0.2) | 1 (0.4) | 8 (0.2) | .337 |
| Cardiac arrest | 0 (0) | 8 (0.6) | 0 (0) | 0 (0) | 8 (0.2) | .764 |
| Myocardial infarction | 2 (0.1) | 1 (0.1) | 1 (0.2) | 0 (0) | 4 (0.1) | .006 |
| Stroke | 1 (0.1) | 2 (0.1) | 0 (0) | 0 (0) | 3 (0.1) | .915 |
| Other complications | 84 (4.8) | 97 (7.2) | 35 (7.8) | 20 (9.0) | 237 (6.3) | .836.007 |
| 30-d surgical mortality | 8 (0.5) | 20 (1.5) | 0 (0) | 2 (0.9) | 30 (0.8) | .003 |
Six patients (0.1%) did not have a recorded cancer site. Data presented as total number (percentage) or median (interquartile range).
Fotopoulou. Gynecologic cancer surgery during the COVID-19 pandemic. Am J Obstet Gynecol 2022.
a
Curative+life-prolonging vs palliative operation
b
Midabdominal=any operation involving mid-abdominal procedures, but not upper-abdominal surgery; Upper-abdominal=any operations involving upper-abdominal procedures.