Comparing Optimal Debulking Surgery Outcomes between Anemic and Non-Anemic Ovarian Cancer Patients at Dr. Hasan Sadikin General  Hospital Bandung in 2022 – 2023

Wenardy Dewanto; Ali Budi Harsono; Muhammad Alamsyah Aziz

doi:10.24198/obgynia.v8i3.948

Comparing Optimal Debulking Surgery Outcomes between Anemic and Non-Anemic Ovarian Cancer Patients at Dr. Hasan Sadikin General Hospital Bandung in 2022 – 2023

Wenardy Dewanto, Ali Budi Harsono, Muhammad Alamsyah Aziz

Abstract

Objective: Ovarian cancer remains one of the most lethal gynecological malignancies. Optimal debulking surgery is one of the treatment options of ovarian cancer. Anemia was commonly observed in ovarian cancer patients, yet its association with the outcome of optimal debulking surgery remains unclear. This study aims to evaluate the association between preoperative anemia and the outcome of optimal debulking surgery.
Methods: A case-control analytical observational study was conducted on 87 ovarian cancer patients who had undergone optimal debulking surgery at Dr. Hasan Sadikin General Hospital in 2022-2023. Data were collected from medical records and was analyzed using Chi-square test.
Results: The majority of ovarian cancer patients at Dr. Hasan Sadikin General Hospital in 2022–2023 presented with mild to moderate anemia, accounting for 37,78% and 33,33% of cases, respectively. Only 24,44% had normal hemoglobin levels, while 4,44% had severe anemia. Optimal debulking was achieved in 76,7% of cases. No significant association was found between preoperative anemia and optimal debulking outcomes (p = 0,601; OR 1,21, 95% CI: 0,68–2,16).
Conclusion: Preoperative anemia was not associated with optimal debulking surgery outcomes.

Perbandingan Keberhasilan Optimal Debulking Surgery antara Pasien Kanker Ovarium dengan Anemia dan Non-Anemia di RSUP Dr. Hasan Sadikin Bandung Tahun 2022 – 2023

Abstrak
Tujuan: Kanker ovarium merupakan salah satu keganasan ginekologi dengan angka kematian tertinggi. Optimal debulking surgery merupakan salah satu terapi utama pada pasien kanker ovarium. Anemia sering ditemukan pada pasien kanker ovarium. Namun, hubungan anemia dan keberhasilan optimal debulking surgery belum jelas. Penelitian ini bertujuan untuk mengevaluasi hubungan anemia preoperatif dan keberhasilan optimal debulking surgery pada pasien kanker ovarium.
Metode: Metode penelitian yang digunakan adalah studi observasional analitik dengan desain case control yang melibatkan pasien kanker ovarium yang menjalani optimal debulking surgery di RSUP Dr. Hasan Sadikin Bandung periode 2022 – 2023. Data diperoleh dari rekam medis dengan total 87 pasien yang memenuhi kriteria inklusi. Analisis hubungan anemia preoperatif dengan keberhasilan optimal debulking surgery dilakukan dengan uji Chi square.
Hasil: Mayoritas pasien kanker ovarium di RSUP Dr. Hasan Sadikin tahun 2022 – 2023 mengalami anemia ringan (37,78%) dan sedang (33,3%). Hanya 24,4% pasien memiliki kadar hemoglobin normal dengan 4,44% pasien mengalami anemia berat. Optimal debulking surgery berhasil dicapai pada 76,6%. Tidak ditemukan hubungan bermakna antara anemia preoperatif dan keberhasilan optimal debulking surgery (p = 0,601; OR 1,21; 95% CI : 0,68-2,16)
Kesimpulan: Hasil penelitian menunjukkan anemia preoperatif tidak berhubungan dengan keberhasilan optimal debulking surgery pada pasien kanker ovarium.

Kata kunci: Anemia; kanker ovarium; optimal debulking surgery

Keywords

ovarian cancer, anemia, optimal debulking surgery

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References

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov 1;68(6):394–424. doi: 10.3322/CAAC.21492

Cabasag CJ., et al. 2022. Ovarian Cancer Today and Tomorrow: A Global Assessment by World Region and Human Development Index using GLOBOCAN 2020. International Journal of Cancer Vol 151(9): 1535-1541

Board PS and PCE. Fatigue (pdq®). PDQ Cancer Inf Summ. 2023 Sep 12;

Wandira NA., Dinengsih S., Novelia S. 2023. Analysis of Ovary Cancer in the Gynecology Room. Jurnal Midpro Vol. 15(1): 166-179

RL S, KD M, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7–30. doi: 10.3322/caac.21590

Maleki Z., et al. 2023. Survival Rate of Ovarian Cancer in Asian Countries: A Systematic Review and Metaanalysis. BMC Cancer Vol 23 (558): 1-11

Momenimovahed Z, Tiznobaik A, Taheri S, Salehiniya H. Ovarian cancer in the world: epidemiology and risk factors. Int J Womens Heal. 2019;11:287–99. doi: 10.2147/IJWH.S197604

Stewart C, Ralyea C, Lockwood S. Ovarian cancer: an integrated review. Semin Oncol Nurs. 2019;35(2):151–6. doi: 10.1016/j.soncn.2019.02.001

Rahmawati H, ER D, RD P. Kanker ovarium. Indones J Clin Pathol Med Lab. 2016;19(1). doi: 10.24293/ijcpml.v19i1.390

Muinao T, HP DB, Pal M. Multi-biomarker panel signature as the key to diagnosis of ovarian cancer. Heliyon. 2019;5(12):e02826. doi: 10.1016/j.heliyon.2019.e02826 Macciò A, Madeddu C, Massa D, al. et. Hemoglobin levels correlate with interleukin-6 levels in patients with advanced untreated epithelial ovarian cancer: role of inflammation in cancer-related anemia. Blood. 2005;106(1):362–7. doi: 10.1182/blood-2005-01-0160

Chen Y, Zhang L, WX L, XY L. Prognostic significance of preoperative anemia, leukocytosis and thrombocytosis in chinese women with epithelial ovarian cancer. Asian Pacific J Cancer Prev. 2015;16(3):933–9. doi: 10.7314/APJCP.2015.16.3.933

GMT H, CD M. Anemia: perioperative risk and treatment opportunity. Anesthesiology. 2021;135(3):520–30. doi: 10.1097/ALN.0000000000003870

Dicato M. Anemia in cancer: some pathophysiological aspects. Oncologist. 2003;8(Suppl 1):19–21. doi: 10.1634/theoncologist.8-suppl_1-19

Muñoz M, Ariza D, Gómez-Ramírez S, Hernández P, García-Erce JA, Leal-Noval SR. Preoperative anemia in elective cardiac surgery: prevalence, risk factors, and influence on postoperative outcome. Transfus Altern Transfus Med. 2010 Jun 1;11(2):47–56. doi: 10.1111/J.1778428X.2010.01126.X;PAGEGROUP:STRING:PUBLICATION

BL MG, Alimena S, MG del C, al. et. Infection, thrombosis, and oncologic outcome after interval debulking surgery: does perioperative blood transfusion matter? Gynecol Oncol. 2019;153(1):63–7. doi: 10.1016/j.ygyno.2019.01.001

Fowler AJ, Ahmad T, Abbott TEF, Torrance HD, Wouters PF, De Hert S, et al. Association of preoperative anaemia with postoperative morbidity and mortality: an observational cohort study in low-, middle-, and high-income countries. Br J Anaesth. 2018 Dec 1;121(6):1227–35. doi: 10.1016/J.BJA.2018.08.026

Fowler AJ, Ahmad T, Phull MK, Allard S, Gillies MA, Pearse RM. Meta-analysis of the association between preoperative anaemia and mortality after surgery. Br J Surg. 2015 Oct 1;102(11):1314–24. doi: 10.1002/BJS.9861,

BJ S, JH M, WF M. Cardiopulmonary physiological responses to heavy exercise in patients with anemia. J Clin Invest. 1960;39(2):378–88. doi: 10.1172/JCI104048

OW F, Vega B, Roque D, al. et. Characterization of pre-operative anemia in patients undergoing surgery by a gynecologic oncologist and association with post-operative complications. Int J Gynecol Cancer. 2023;33(11):1778–85. doi: 10.1136/ijgc-2023-004539

DOI: http://dx.doi.org/10.24198/obgynia.v8i3.948