Appropriate triage allows aggressive primary debulking surgery with rates of morbidity and mortality comparable to interval surgery after chemotherapy
Surgery for ovarian cancer is hazardous, with mortality rates of approximately 2% within 90 days and morbidity causing extended hospital stays beyond 10 days of up to 30%. There is a trend to more radical or extended surgery at initial presentation. Because of the hazard, surgery is frequently delayed with chemotherapy being used as initial treatment to decrease tumour bulk.
This retrospective study from the Mayo looks at 650 women with stage III/IV ovarian cancer and used triage evaluation to assess operative risk. The triage involve a measure of serum protein (albumin), the age of the patient >75, and mobility.
If women had low scores using the triage assessment, there was a significant increase in mortality to about 6%. It is suggested that these women, who are at high risk, should have delayed primary surgery.
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