Is Cardiopulmonary Exercise Testing Predictive of Surgical Complications in Patients Undergoing Surgery for Ovarian Cancer?
Preoperative cardiopulmonary exercise testing (CPET) provides an objective assessment of functional capability. In other intra-abdominal surgical specialties, CPET outcomes are predictive of operative morbidity. However, in ovarian cancer surgery, its predictive value remains unknown. In this study,...
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| Format: | Article |
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MDPI AG
2023-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/21/5185 |
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| author | Anke Smits Claire-Marie Agius Dominic Blake Christine Ang Ali Kucukmetin Maaike van Ham Johanna M. A. Pijnenborg Joanne Knight Stuart Rundle |
| author_facet | Anke Smits Claire-Marie Agius Dominic Blake Christine Ang Ali Kucukmetin Maaike van Ham Johanna M. A. Pijnenborg Joanne Knight Stuart Rundle |
| author_sort | Anke Smits |
| collection | DOAJ |
| description | Preoperative cardiopulmonary exercise testing (CPET) provides an objective assessment of functional capability. In other intra-abdominal surgical specialties, CPET outcomes are predictive of operative morbidity. However, in ovarian cancer surgery, its predictive value remains unknown. In this study, we evaluated the association between CPET performance and surgical morbidity in ovarian cancer patients. Secondly, we assessed the association between CPET performance and other surgical outcomes (i.e., hospital stay, readmission and residual disease). This was a retrospective cohort study of patients undergoing primary surgery for ovarian cancer between 2020 and 2023. CPET performance included peak oxygen uptake (VO<sub>2</sub> max), ventilatory efficiency (VE/VO<sub>2</sub>) and anaerobic threshold. Outcomes were operative morbidity and included intra- and postoperative complications (Clavien–Dindo), hospital stay, readmission within 30 days and residual disease. A total of 142 patients were included. A lower VO<sub>2</sub> peak and a higher VE/VCO<sub>2</sub> were both associated with the occurrence of postoperative complications, and a poorer anaerobic threshold was associated with more transfusions. VE/VCO<sub>2</sub> remained significantly associated after multivariate analysis (<i>p</i> = 0.035). None of the CPET outcomes were associated with length of stay, readmission or residual disease. In conclusion, VE/VCO<sub>2</sub> was significantly associated with an increased risk of all-cause postoperative complications in ovarian cancer patients undergoing primary surgery. |
| first_indexed | 2024-03-11T11:32:57Z |
| format | Article |
| id | doaj.art-b9f87d163c134b19bc5f522e3313d8d9 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T11:32:57Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-b9f87d163c134b19bc5f522e3313d8d92023-11-10T15:00:09ZengMDPI AGCancers2072-66942023-10-011521518510.3390/cancers15215185Is Cardiopulmonary Exercise Testing Predictive of Surgical Complications in Patients Undergoing Surgery for Ovarian Cancer?Anke Smits0Claire-Marie Agius1Dominic Blake2Christine Ang3Ali Kucukmetin4Maaike van Ham5Johanna M. A. Pijnenborg6Joanne Knight7Stuart Rundle8Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead NE9 6SX, UKDepartment of Anaesthetics, Queen Elizabeth Hospital, Gateshead NE9 6SX, UKNorthern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead NE9 6SX, UKNorthern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead NE9 6SX, UKNorthern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead NE9 6SX, UKDepartment of Gynaecological Oncology, Radboudumc, 6525 GA Nijmegen, The NetherlandsDepartment of Gynaecological Oncology, Radboudumc, 6525 GA Nijmegen, The NetherlandsDepartment of Anaesthetics, Queen Elizabeth Hospital, Gateshead NE9 6SX, UKNorthern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead NE9 6SX, UKPreoperative cardiopulmonary exercise testing (CPET) provides an objective assessment of functional capability. In other intra-abdominal surgical specialties, CPET outcomes are predictive of operative morbidity. However, in ovarian cancer surgery, its predictive value remains unknown. In this study, we evaluated the association between CPET performance and surgical morbidity in ovarian cancer patients. Secondly, we assessed the association between CPET performance and other surgical outcomes (i.e., hospital stay, readmission and residual disease). This was a retrospective cohort study of patients undergoing primary surgery for ovarian cancer between 2020 and 2023. CPET performance included peak oxygen uptake (VO<sub>2</sub> max), ventilatory efficiency (VE/VO<sub>2</sub>) and anaerobic threshold. Outcomes were operative morbidity and included intra- and postoperative complications (Clavien–Dindo), hospital stay, readmission within 30 days and residual disease. A total of 142 patients were included. A lower VO<sub>2</sub> peak and a higher VE/VCO<sub>2</sub> were both associated with the occurrence of postoperative complications, and a poorer anaerobic threshold was associated with more transfusions. VE/VCO<sub>2</sub> remained significantly associated after multivariate analysis (<i>p</i> = 0.035). None of the CPET outcomes were associated with length of stay, readmission or residual disease. In conclusion, VE/VCO<sub>2</sub> was significantly associated with an increased risk of all-cause postoperative complications in ovarian cancer patients undergoing primary surgery.https://www.mdpi.com/2072-6694/15/21/5185ovarian cancersurgerycardiopulmonary exercise testingcomplications |
| spellingShingle | Anke Smits Claire-Marie Agius Dominic Blake Christine Ang Ali Kucukmetin Maaike van Ham Johanna M. A. Pijnenborg Joanne Knight Stuart Rundle Is Cardiopulmonary Exercise Testing Predictive of Surgical Complications in Patients Undergoing Surgery for Ovarian Cancer? Cancers ovarian cancer surgery cardiopulmonary exercise testing complications |
| title | Is Cardiopulmonary Exercise Testing Predictive of Surgical Complications in Patients Undergoing Surgery for Ovarian Cancer? |
| title_full | Is Cardiopulmonary Exercise Testing Predictive of Surgical Complications in Patients Undergoing Surgery for Ovarian Cancer? |
| title_fullStr | Is Cardiopulmonary Exercise Testing Predictive of Surgical Complications in Patients Undergoing Surgery for Ovarian Cancer? |
| title_full_unstemmed | Is Cardiopulmonary Exercise Testing Predictive of Surgical Complications in Patients Undergoing Surgery for Ovarian Cancer? |
| title_short | Is Cardiopulmonary Exercise Testing Predictive of Surgical Complications in Patients Undergoing Surgery for Ovarian Cancer? |
| title_sort | is cardiopulmonary exercise testing predictive of surgical complications in patients undergoing surgery for ovarian cancer |
| topic | ovarian cancer surgery cardiopulmonary exercise testing complications |
| url | https://www.mdpi.com/2072-6694/15/21/5185 |
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