In a recent analysis, advancing age, increasing stage, and increasing comorbidity score were all associated with an increase in 30-day mortality among women who had surgery for advanced ovarian cancer.

Melissa M. Thrall, MD, MPH, of the University of Washington in Seattle, and fellow investigators culled Medicare and Surveillance, Epidemiology, and End Results (SEER) data for 5,475 women 65 years and older who had undergone primary debulking surgery for stage III or stage IV epithelial ovarian cancer. Overall 30-day mortality was found to be 8.2%. However, that rate jumped to 20.1% among women who had been admitted emergently, and fell to 5.6% among women admitted electively.

Women admitted electively who were 75 years or older with stage IV disease, or with stage III disease and a comorbidity score of 1 or higher, proved to be a high-risk group, with an observed 30-day mortality of 12.7%.   

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Thrall and colleagues concluded in Obstetrics & Gynecology (2011;118[3]:537-547) that age, cancer stage, and comorbidity scores may help stratify postoperative mortality risk among women electively admitted for debulking surgery. If validated in a prospective cohort, these factors could help identify women who would benefit from alternative treatment strategies.