ArticleAnnals of surgical oncology2025
Postoperative Complications After Cytoreductive Surgery for Advanced Ovarian Carcinoma: A Single-Center Analysis Exploring the Value of the Comprehensive Complication Index and the Predictors of High Complications Burden.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Preoperative PARP Inhibitors in Ovarian Cancer Trials: Connecting Molecular Oncology and Cytoreductive Surgery.Cancers · 2026Review
- Predictors of postoperative morbidity and delayed initiation of adjuvant chemotherapy after cytoreductive surgery in advanced-stage epithelial ovarian cancer.World journal of surgical oncology · 2026Article
- Enhanced Recovery After Surgery in Cytoreductive Surgery With HIPEC: Implementation and Outcomes From a High-Volume Tertiary Centre in a Lower-Middle Income Country.Journal of surgical oncology · 2026Article
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11 authors.
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Abstract
backgroundThe comprehensive complication index (CCI) reflects the overall patient complication burden on a 0-100 scale. This single-institution retrospective analysis explores the accuracy of CCI in describing complications following cytoreductive surgery for advanced high-grade ovarian carcinoma (HGOC) and aims to identify predictive factors of high complication burden. PATIENTS AND
methodsIn total, 304 patients who underwent cytoreductive surgery for FIGO stage IIIA-IVB HGOC at our institution from 2015 to 2023 were analyzed. Each complication's severity was graded using the Clavien-Dindo classification. The CCI was used to quantify the global complications burden, and patients were stratified into three groups: CCI-low (< 26.2), CCI-intermediate (26 ≤ CCI < 33.7), and CCI-high (≥ 33.7).
resultsOf the 200 patients (65.8%) with at least one complication, 127 (41.8%) were CCI-low, 32 (10.5%) CCI-intermediate, and 41 (13.5%) CCI-high. Median hospitalization duration (p < 0.0001) and readmission rates (p < 0.0001) correlated with CCI categories, reflecting increased CCI scores with greater surgical complexity, as assessed by the Aletti surgical complexity score (SCS). Univariate analysis showed a significant association between CCI-high and FIGO stage, surgical complexity, diaphragmatic procedures, multiple bowel resections, length of surgery and intraoperative blood loss. Multivariate analysis confirmed FIGO stage (odds ratio [OR] 2.57), multiple bowel resections (OR 5.61), and blood loss (OR 1.93) as independent risk factors for high complication burden.
conclusionsThe CCI is a good descriptor of postoperative complications in patients undergoing cytoreductive surgery for advanced HGOC by integrating both the severity and number of complications into a single, easily usable, and intuitive quantitative score. FIGO stage, multiple bowel resections, and blood loss-but not surgical timing-are independent predictors of a high complication burden.
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