Quality of life from cytoreductive surgery in advanced Ovarian cancer: investigating association with disease burden and surgical complexity in the international, prospective, SOCQER2 cohort study

Sudha Sundar; Carole Cummins; Satyam Kumar; J. Long; V. Arora; J. Balega; T. Broadhead; T. Duncan; R. Edmondson; C. Fotopoulou; R. Glasspool; D. Kolomainen; S. Leeson; R. Manchanda; O. McNally; J.  Morrison; A. Mukhopadhyay; J. Paul; J. Tidy; N. Wood

doi:10.1111/1471-0528.17041

Quality of life from cytoreductive surgery in advanced Ovarian cancer: investigating association with disease burden and surgical complexity in the international, prospective, SOCQER2 cohort study

Sudha Sundar, Carole Cummins, Satyam Kumar, J. Long, V. Arora, J. Balega, T. Broadhead, T. Duncan, R. Edmondson, C. Fotopoulou, R. Glasspool, D. Kolomainen, S. Leeson, R. Manchanda, O. McNally, J. Morrison, A. Mukhopadhyay, J. Paul, J. Tidy, N. Wood

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Abstract

Objective: To investigate quality of life (QoL) and association with surgical complexity and disease burden after surgical resection for advanced ovarian cancer in centres with variation in surgical approach

Design: Prospective multicentre observational study

Setting: United Kingdom, Kolkata, India, and Melbourne, Australia gynaecological cancer surgery centres.

Participants: Patients undergoing surgical resection for late stage ovarian cancer.

Exposure: Low, intermediate or high Surgical Complexity Score (SCS) surgery

Main outcomes and measures: Primary: EORTC-QLQ-C30 Global score change. Secondary: EORTC OV28, progression free survival.

Results: Patients’ pre-operative disease burden and SCS varied between centres, confirming differences in surgical ethos. QoL response rates were 90% up to 18 months. Mean change from the pre-surgical baseline in the EORTC QLQ-C30 was 3.4 (SD 1.8, n=88) in the low, 4.0 (SD 2.1, n=55) in the intermediate and 4.3 (SD 2.1, n=52) in the high SCS group after 6 weeks (p=0.048) and 4.3 (SD 2.1, n=51), 5.1 (SD 2.2, n=41) and 5.1 (SD 2.2, n=35) respectively after 12 months (p=0.133). In a repeated measures model, there were no clinically or statistically meaningful differences in EORTC QLQ-C30 global scores between the three SCS groups, p= 0.840 but there was a small statistically significant improvement in all groups over time (p<0.001). The high SCS group experienced small to moderate decreases in physical (p=0.004), role (p=0.016) and emotional (p=0.001) function at 6 weeks post-surgery which resolved by 6-12 months.

Conclusions and relevance: Global QoL of patients undergoing low, intermediate, and high SCS surgery improved at 12 months post operation and was no worse in patients undergoing extensive surgery.

Tweetable abstract
Extensive surgery compared to lower complexity surgery does not result in poorer quality of life in patients with advanced ovarian cancer.

Original language	English
Journal	BJOG: An International Journal of Obstetrics & Gynaecology
Early online date	5 Dec 2021
DOIs	https://doi.org/10.1111/1471-0528.17041
Publication status	E-pub ahead of print - 5 Dec 2021

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SundarS2021Quality
This is the peer reviewed version of the following article: (see citation), which has been published in final form at https://doi.org/10.1111/1471-0528.17041. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited
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Sundar, S., Cummins, C., Kumar, S., Long, J., Arora, V., Balega, J., Broadhead, T., Duncan, T., Edmondson, R., Fotopoulou, C., Glasspool, R., Kolomainen, D., Leeson, S., Manchanda, R., McNally, O., Morrison, J., Mukhopadhyay, A., Paul, J., Tidy, J., & Wood, N. (2021). Quality of life from cytoreductive surgery in advanced Ovarian cancer: investigating association with disease burden and surgical complexity in the international, prospective, SOCQER2 cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. Advance online publication. https://doi.org/10.1111/1471-0528.17041

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title = "Quality of life from cytoreductive surgery in advanced Ovarian cancer: investigating association with disease burden and surgical complexity in the international, prospective, SOCQER2 cohort study",

abstract = "Objective: To investigate quality of life (QoL) and association with surgical complexity and disease burden after surgical resection for advanced ovarian cancer in centres with variation in surgical approachDesign: Prospective multicentre observational studySetting: United Kingdom, Kolkata, India, and Melbourne, Australia gynaecological cancer surgery centres. Participants: Patients undergoing surgical resection for late stage ovarian cancer. Exposure: Low, intermediate or high Surgical Complexity Score (SCS) surgery Main outcomes and measures: Primary: EORTC-QLQ-C30 Global score change. Secondary: EORTC OV28, progression free survival.Results: Patients{\textquoteright} pre-operative disease burden and SCS varied between centres, confirming differences in surgical ethos. QoL response rates were 90% up to 18 months. Mean change from the pre-surgical baseline in the EORTC QLQ-C30 was 3.4 (SD 1.8, n=88) in the low, 4.0 (SD 2.1, n=55) in the intermediate and 4.3 (SD 2.1, n=52) in the high SCS group after 6 weeks (p=0.048) and 4.3 (SD 2.1, n=51), 5.1 (SD 2.2, n=41) and 5.1 (SD 2.2, n=35) respectively after 12 months (p=0.133). In a repeated measures model, there were no clinically or statistically meaningful differences in EORTC QLQ-C30 global scores between the three SCS groups, p= 0.840 but there was a small statistically significant improvement in all groups over time (p<0.001). The high SCS group experienced small to moderate decreases in physical (p=0.004), role (p=0.016) and emotional (p=0.001) function at 6 weeks post-surgery which resolved by 6-12 months. Conclusions and relevance: Global QoL of patients undergoing low, intermediate, and high SCS surgery improved at 12 months post operation and was no worse in patients undergoing extensive surgery.Tweetable abstractExtensive surgery compared to lower complexity surgery does not result in poorer quality of life in patients with advanced ovarian cancer. ",

author = "Sudha Sundar and Carole Cummins and Satyam Kumar and J. Long and V. Arora and J. Balega and T. Broadhead and T. Duncan and R. Edmondson and C. Fotopoulou and R. Glasspool and D. Kolomainen and S. Leeson and R. Manchanda and O. McNally and J. Morrison and A. Mukhopadhyay and J. Paul and J. Tidy and N. Wood",

year = "2021",

month = dec,

day = "5",

doi = "10.1111/1471-0528.17041",

language = "English",

journal = "BJOG: An International Journal of Obstetrics & Gynaecology",

issn = "1470-0328",

publisher = "Wiley",

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Sundar, S , Cummins, C, Kumar, S, Long, J, Arora, V, Balega, J, Broadhead, T, Duncan, T, Edmondson, R, Fotopoulou, C, Glasspool, R, Kolomainen, D, Leeson, S, Manchanda, R, McNally, O, Morrison, J, Mukhopadhyay, A, Paul, J, Tidy, J & Wood, N 2021, 'Quality of life from cytoreductive surgery in advanced Ovarian cancer: investigating association with disease burden and surgical complexity in the international, prospective, SOCQER2 cohort study', BJOG: An International Journal of Obstetrics & Gynaecology. https://doi.org/10.1111/1471-0528.17041

Quality of life from cytoreductive surgery in advanced Ovarian cancer: investigating association with disease burden and surgical complexity in the international, prospective, SOCQER2 cohort study. / Sundar, Sudha ; Cummins, Carole; Kumar, Satyam et al.
In: BJOG: An International Journal of Obstetrics & Gynaecology, 05.12.2021.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Quality of life from cytoreductive surgery in advanced Ovarian cancer

T2 - investigating association with disease burden and surgical complexity in the international, prospective, SOCQER2 cohort study

AU - Sundar, Sudha

AU - Cummins, Carole

AU - Kumar, Satyam

AU - Long, J.

AU - Arora, V.

AU - Balega, J.

AU - Broadhead, T.

AU - Duncan, T.

AU - Edmondson, R.

AU - Fotopoulou, C.

AU - Glasspool, R.

AU - Kolomainen, D.

AU - Leeson, S.

AU - Manchanda, R.

AU - McNally, O.

AU - Morrison, J.

AU - Mukhopadhyay, A.

AU - Paul, J.

AU - Tidy, J.

AU - Wood, N.

PY - 2021/12/5

Y1 - 2021/12/5

N2 - Objective: To investigate quality of life (QoL) and association with surgical complexity and disease burden after surgical resection for advanced ovarian cancer in centres with variation in surgical approachDesign: Prospective multicentre observational studySetting: United Kingdom, Kolkata, India, and Melbourne, Australia gynaecological cancer surgery centres. Participants: Patients undergoing surgical resection for late stage ovarian cancer. Exposure: Low, intermediate or high Surgical Complexity Score (SCS) surgery Main outcomes and measures: Primary: EORTC-QLQ-C30 Global score change. Secondary: EORTC OV28, progression free survival.Results: Patients’ pre-operative disease burden and SCS varied between centres, confirming differences in surgical ethos. QoL response rates were 90% up to 18 months. Mean change from the pre-surgical baseline in the EORTC QLQ-C30 was 3.4 (SD 1.8, n=88) in the low, 4.0 (SD 2.1, n=55) in the intermediate and 4.3 (SD 2.1, n=52) in the high SCS group after 6 weeks (p=0.048) and 4.3 (SD 2.1, n=51), 5.1 (SD 2.2, n=41) and 5.1 (SD 2.2, n=35) respectively after 12 months (p=0.133). In a repeated measures model, there were no clinically or statistically meaningful differences in EORTC QLQ-C30 global scores between the three SCS groups, p= 0.840 but there was a small statistically significant improvement in all groups over time (p<0.001). The high SCS group experienced small to moderate decreases in physical (p=0.004), role (p=0.016) and emotional (p=0.001) function at 6 weeks post-surgery which resolved by 6-12 months. Conclusions and relevance: Global QoL of patients undergoing low, intermediate, and high SCS surgery improved at 12 months post operation and was no worse in patients undergoing extensive surgery.Tweetable abstractExtensive surgery compared to lower complexity surgery does not result in poorer quality of life in patients with advanced ovarian cancer.

AB - Objective: To investigate quality of life (QoL) and association with surgical complexity and disease burden after surgical resection for advanced ovarian cancer in centres with variation in surgical approachDesign: Prospective multicentre observational studySetting: United Kingdom, Kolkata, India, and Melbourne, Australia gynaecological cancer surgery centres. Participants: Patients undergoing surgical resection for late stage ovarian cancer. Exposure: Low, intermediate or high Surgical Complexity Score (SCS) surgery Main outcomes and measures: Primary: EORTC-QLQ-C30 Global score change. Secondary: EORTC OV28, progression free survival.Results: Patients’ pre-operative disease burden and SCS varied between centres, confirming differences in surgical ethos. QoL response rates were 90% up to 18 months. Mean change from the pre-surgical baseline in the EORTC QLQ-C30 was 3.4 (SD 1.8, n=88) in the low, 4.0 (SD 2.1, n=55) in the intermediate and 4.3 (SD 2.1, n=52) in the high SCS group after 6 weeks (p=0.048) and 4.3 (SD 2.1, n=51), 5.1 (SD 2.2, n=41) and 5.1 (SD 2.2, n=35) respectively after 12 months (p=0.133). In a repeated measures model, there were no clinically or statistically meaningful differences in EORTC QLQ-C30 global scores between the three SCS groups, p= 0.840 but there was a small statistically significant improvement in all groups over time (p<0.001). The high SCS group experienced small to moderate decreases in physical (p=0.004), role (p=0.016) and emotional (p=0.001) function at 6 weeks post-surgery which resolved by 6-12 months. Conclusions and relevance: Global QoL of patients undergoing low, intermediate, and high SCS surgery improved at 12 months post operation and was no worse in patients undergoing extensive surgery.Tweetable abstractExtensive surgery compared to lower complexity surgery does not result in poorer quality of life in patients with advanced ovarian cancer.

U2 - 10.1111/1471-0528.17041

DO - 10.1111/1471-0528.17041

M3 - Article

SN - 1470-0328

JO - BJOG: An International Journal of Obstetrics & Gynaecology

JF - BJOG: An International Journal of Obstetrics & Gynaecology

ER -

Sundar S , Cummins C, Kumar S, Long J, Arora V, Balega J et al. Quality of life from cytoreductive surgery in advanced Ovarian cancer: investigating association with disease burden and surgical complexity in the international, prospective, SOCQER2 cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2021 Dec 5. Epub 2021 Dec 5. doi: 10.1111/1471-0528.17041

Quality of life from cytoreductive surgery in advanced Ovarian cancer: investigating association with disease burden and surgical complexity in the international, prospective, SOCQER2 cohort study

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