Morbidity and mortality associated with primary and repeat operations for ovarian cancer

Aggressive surgery may improve the outcome of patients with ovarian cancer. To assess the risk of operative complications, we analyzed 472 primary and 299 repeat operations for ovarian cancer in 536 women between 14-91 years of age. Intraoperative bleeding estimated to be over 1000 mL (N = 107) was more common after primary (21%) than repeat surgery (3%). Urinary tract infection accompanied 113 operations (18% of primary and 9% of repeat), bowel complication 51 operations (7% of primary and 6% of repeat), fever 23 operations (4% of primary and 1% of repeat), wound complication 17 operations (3% of primary and 1% of repeat), and thromboembolism 11 operations (2% of primary and 0.3% of repeat). Patient age had no effect on the rate of complications. Pelvic and para-aortic lymphadenectomy in connection with primary operations caused substantial blood loss. Five subjects (1%) died after primary operations. On the whole, the surgical procedures, especially repeat operations, were well tolerated and should not be avoided for fear of complications.