An Audit on Factors Delaying Time to Chemotherapy in Stage IIB–IV Ovarian Cancer Patients After Primary Debulking Surgery

To identify risk factors associated with delay in adjuvant chemotherapy in ovarian cancer patients.

This is single institute retrospective study. All patients of highgrade epithelial ovarian, fallopian tube, and primary peritoneal carcinoma, FIGO Stage II–IV, who underwent PDS at our institution from January 2018 to December 2019 were included. Patients were excluded if they had non-epithelial ovarian histology, borderline tumors, or if they were declared unresectable or R-2 (> 2 cm residual tumor) resection at the end of surgery, synchronous tumors or if they received chemotherapy from outside our institution. The demographic data, biochemical parameters and surgical complexity score was recorded and analyzed statistically.

We identified a total of 102 patients who met the inclusion criteria with a mean age of 60.1 years, SD 11.4. Of these, 22 patients (21.6%) experienced a delay in chemotherapy and 80 patients (78.4%) started chemotherapy without any delay. Our study highlighted that age > 65 years, low albumin preoperatively < 3.5 gm/dl, higher Clavin-Dindo scores (3–5) in the postoperative period was significantly associated with delay in chemotherapy after multivariate analysis.

This study enables the oncologist to understand factors that delay chemotherapy in advanced ovarian cancers post-surgery and would help in customizing the treatment for patients for better outcomes, target the delay group for high compliance and work towards improving the timeliness of chemotherapy initiation, enhancing patient outcomes to optimize the overall management of advanced ovarian cancer.