The role of factor XIII in surgery for advanced stage of epithelial ovarian cancer

Yazdian, Mahtab; Groeben, Harald; Ataseven, Beyhan; Schneider, Stephanie; Baert, Thais; Bommert, Mareike; Traut, Alexander; Elfers-Wassenhoven, Alexandra; Brüß, Ulrich; Schwameis, Richard; du Bois, Andreas; Wagner, Uwe und Harter, Philipp (2021): The role of factor XIII in surgery for advanced stage of epithelial ovarian cancer. In: Archives of Gynecology and Obstetrics, Bd. 305, Nr. 5: S. 1311-1318

Abstract

Introduction Hereditary factor (F) XIII-deficiency is a known risk factor for postoperative complications, but data of acquired FXIII-deficiency in malignancies are limited. Therefore, we evaluated the role of acquired FXIII-deficiency in surgery for advanced epithelial ovarian cancer (EOC). Materials and methods We performed a retrospective analysis of patients with known serum FXIII status and treatment between 2011 and 2018 at our center. We defined cohorts according to FXIII with values > 75% as normal (group A), 55-75% as reduced (group B) and < 55% as low (group C). Complications were classified according to the Clavien-Dindo Classification, class III-V complications were defined as severe. Results 347 patients with EOC were identified. 180 patients (51.2%) were in group A, 82 patients (23.6%) in group B, and 85 patients (24.4%) in group C. Lower levels of FXIII were associated with higher amount of ascites, FIGO IV, high grade serous histology, low albumin, and higher CA-125 levels. Regarding intraoperative variables, low FXIII was associated with longer duration of surgery, higher blood loss, higher surgical complexity score/number of bowel anastomosis and a higher probability for macroscopic residual disease. The risk of severe complications in group A was 12.2%, 24.4% in group B, and 31.8% in group C. In a multivariate model, low FXIII (OR 2.8), > 1 bowel anastomosis (OR 2.7), age-adjusted Charlson comorbidity index >= 4 (OR 3.6) and a longer duration of surgery (> 285 min.) were significant predictive factors for severe complications. Conclusion FXIII is associated with tumor and treatment burden. A low level of FXIII is associated with postoperative complications. The knowledge about the presurgical serum FXIII-level might be helpful to plan the treatment strategy.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0932-0067
• Sprache: Englisch