Risk factors for postoperative delayed gastric emptying in ovarian cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Table 1 Patients data (n = 77)

Characteristic	Value
Age (yr, median and range)	59 (35-75)
BMI (kg/m2, median and range)	22.83 (13.8-33.98)
Concomitant disease, n (%)
Diabetes mellitus	8 (10)
High blood pressure	16 (21)
History of chemotherapy (cycles, median and range)	6 (0-25)
Pelvic surgical history, n (%)	62 (81)
Serum CA-125 level (U/mL, median and range)	277.2 (7.2-10001.0)
Primary/recurrent ovarian cancer, n (%)
Primary	32 (42)
Recurrent	45 (58)
FIGO stage for primary ovarian cancer (n)
IIIB	7
IIIC	4
IVB	21
Histology, n (%)
Serous	55 (71)
Others	22 (29)

BMI: Body mass index.

Table 2 Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy characteristics (n = 77)

Characteristic	Value
Operation time (minute, median and range)	630 (280-960)
Intraoperative hemorrhage (mL, median and range)	600 (50-5000)
Number of organs resected (median and range)	2 (0-9)
Resected organs, n (%)
Ascending colon	18 (23)
Transverse colon	4 (5)
Descending colon	5 (6)
Sigmoid colon	19 (25)
Total colon	3 (4)
Stomach (partial)	3 (4)
Small intestine (partial)	13 (17)
Rectum	46 (60)
Liver (partial)	3 (4)
Spleen	7 (9)
Pancreas (partial)	1 (1)
Gallbladder	8 (10)
Omentectomy, n (%)	56 (73)
Urinary bladder, n (%)	2 (3)
Number of bowel resection, n (%)	53 (69)
PCI (median and range)	16 (1-39)
CCS, n (%)
CC 0-1	60 (78)
CC 2-3	17 (22)
Chemotherapeutic agent, n (%)
Docetaxel	4 (5)
Docetaxel + carboplatin	55 (71)
Mitomycin + docetaxel	4 (5)
Mitomycin + carboplatin	14 (19)

CC: Cytoreduction; CCS: Cytoreduction scoring; PCI: Peritoneal cancer index.

Table 3 Univariate analysis of risk factors associated with delayed gastric emptying after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Variable	n	DGE		X2	P value
		Yes	No
Age (yr)				2.697	0.101
≥ 70	9	6	3
< 70	68	22	46
BMI (kg/m2)				5.059	0.025
≥ 23	35	8	27
< 23	42	20	22
Pelvic surgery history				4.498	0.034
Yes	62	19	43
No	15	9	6
Comorbidity (DM/HBP)				2.802	0.094
Yes	24	12	12
No	53	16	37
History of chemotherapy				4.334	0.037
≥ 7 cycles	34	8	26
< 7 cycles	43	20	23
CA-125 level				0.990	0.320
Normal (< 35 U/mL)	12	2	10
Elevated (≥ 35 U/mL)	65	25	40
Pleural effusion before surgery				0.359	0.549
Yes	19	8	11
No	58	20	38
PCI				1.967	0.161
≥ 10	52	22	30
< 10	14	2	12
Diaphragmatic invasion				0.717	0.397
Yes	23	10	13
No	54	18	36
Perigastric and gastric dissection				0.648	0.421
Yes	13	6	7
No	64	22	42
Operation time				4.827	0.047
≥ 7 h	65	27	38
7 h	12	1	11
Intraoperative hemorrhage				7.112	0.008
≥ 800 mL	29	16	13
< 800 mL	48	12	36
Anastomosis				3.634	0.057
Yes	53	23	30
No	24	5	19
Number of organs removed				2.495	0.114
≥ 4	27	13	14
< 4	50	15	35
Pleural effusion after surgery				3.667	0.056
Yes	44	20	24
No	33	8	25

DGE: Delayed gastric emptying; PCI: Peritoneal cancer index.

Table 4 Multivariate analysis of risk factors associated with delayed gastric emptying after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Variable	OR	95% Confidence interval		P value
		Lower	Upper
Age (yr)
≥ 70	7.127	1.122	45.264	0.037
< 70	1
Intraoperative hemorrhage
≥ 800 mL	3.416	1.067	10.939	0.039
< 800 mL	1
BMI (kg/m2)
≥ 23	0.450	0.147	1.379	0.162
< 23	1
Operation time
≥ 7 h	3.206	0.329	31.226	0.316
< 7 h	1
History of abdominal surgery
Yes	0.787	0.175	3.538	0.755
No	1
History of chemotherapy
≥ 7 cycles	0.301	0.078	1.167	0.082
< 7 cycles	1

BMI: Body mass index.