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Clinical pathways of recovery after surgery for advanced ovarian/tubal/peritoneal cancer: an NSGO-MaNGO international survey in collaboration with AGO-a focus on surgical aspects

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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  1. Phase 2 study of the Exportin 1 inhibitor selinexor in patients with recurrent gynecological malignancies

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Niraparib in Patients with Newly Diagnosed Advanced Ovarian Cancer

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Elisa Piovano
  • Annamaria Ferrero
  • Paolo Zola
  • Christian Marth
  • Mansoor Raza Mirza
  • Kristina Lindemann
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OBJECTIVES: This survey assessed the implementation of enhanced recovery after surgery (ERAS) for patients undergoing surgery for advanced ovarian cancer in three European cooperative study groups in Scandinavia, Italy, and Austria. The aim was to evaluate the landscape for future trials on ERAS pathways in ovarian cancer, because high-level evidence for such interventions is lacking.

METHODS: In July 2017, a web-based questionnaire (SurveyMonkey Inc, Palo Alto, CA, USA) was sent to centers conducting surgery for advanced ovarian cancer within the Nordic Society of Gynecologic Oncology (NSGO), Mario Negri Gynecologic Oncology Group (MaNGO) and other Italian institutions, and the Association for Gynecologic Oncology Austria (AGO Austria) (n = 100). The survey covered all aspects of an ERAS pathway including surgery, nursing, and anesthesia. We herein report on the survey findings relating to surgery, including nursing care issues; however, anesthesiologic issues will be discussed in a separate report.

RESULTS: The overall response rate was 62%. Only a third of the centers in Italy and Austria follow a written ERAS protocol compared with 60% of the Scandinavian centers. Only a minority of centers have completely abandoned bowel preparation, with the highest proportion in Scandinavia (36%). Two hours of fasting for fluids before surgery is routinely practiced in Scandinavia and Austria (67-57%, respectively), but not in Italy (5%). Carbohydrate loading is routinely administered only in Scandinavia (67%). Peritoneal drainage is used by 22% routinely and by 61% in cases of bowel resection/lymphadenectomy/peritonectomy. Early feeding with a light diet on day 0 or 1 is the standard of care in Scandinavia and Austria, but not in Italy.

CONCLUSIONS: The degree of implementation of ERAS protocols varies across and within cooperative groups. The centralization of ovarian cancer care seems to facilitate standardization of peri-operative protocols. Currently, the high heterogeneity in patterns of care may challenge an international approach to a clinical trial.

OriginalsprogEngelsk
TidsskriftInternational journal of gynecological cancer : official journal of the International Gynecological Cancer Society
Vol/bind29
Udgave nummer1
Sider (fra-til)181-187
Antal sider7
ISSN1048-891X
DOI
StatusUdgivet - jan. 2019

Bibliografisk note

© IGCS and ESGO 2019. No commercial re-use. See rights and permissions. Published by BMJ.

ID: 59074641