Abstract
AIMS:
to
investigate whether
first referral to the Emergency Department (ED) of a
General Hospital is an independent risk-factor for suboptimal debulking
compared to a similar population electively admitted to cytoreductive
surgery, in a cohort of 307 AOC patients.
METHODS:
this
is a multicentre case-control study, analyzing a cohort of 307 AOC
patients treated at San Raffaele Hospital of
Milan (111 Center A) and
Gemelli Hospital of
Rome (196 Center B) between January 2006/2008 and
December 2010. Women are classified as patients admitted to the Hospital
from ED (Cases) and out-patients (Controls).
RESULTS:
At
univariate analysis, Cases significantly differ from Controls in terms
of worse ECOG PS, larger ascites, pleuric effusion and peritoneal
carcinomatosis. The rate of optimal cytoreduction is statistically lower
in the Cases than Controls. At multivariate analysis, significant
independent predictors for suboptimal residual disease resulted ED
admission, peritoneal carcinosis and mesenteral involvement, supra
radical surgery.
CONCLUSIONS:
Patients admitted from
Emergency Department may have a lower likelihood of optimal
cytoreduction, due to their poor clinical characteristics and large
diffusion of the disease
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