Same day discharge after minimally invasive interval debulking surgery in advanced stage ovarian cancer

To describe the use of and outcomes after same day discharge (SDD) after minimally invasive interval debulking surgery (MI-IDS) for advanced epithelial ovarian cancer (EOC).

We identified patients diagnosed with advanced EOC between 2010 and 2021 who received care in Commission on Cancer Accredited programs and underwent MI-IDS following neoadjuvant chemotherapy. We quantified trends in SDD and its association with patient, clinical, and hospital characteristics. We estimated associations between SDD and 30-day readmissions and 90-day postoperative mortality using univariable and multivariable logistic regression.

Of 3464 patients, 363 (10.5%) underwent SDD, increasing from 1.3% in 2010 to 14.8% in 2021 (average annual increase 0.75 percentage points; 95% CI 0.34% - 1.16%). Compared with admitted patients, those underwent SDD were younger (63.8 vs 65.1 years, p = 0.04), resided in high income zip codes (42.7% vs 35.2%, p = 0.005), had stage IV disease (50.7% vs 43.1%, p = 0.01), had no residual disease after IDS (52.6% vs 40.5%, p < 0.001), received care in the Northeast (20.4% vs 16.7%) or West (25.1% vs 20.7%, p < 0.001) regions and in metropolitan locations (87.9% vs 83.0%, p = 0.04). Readmission and 90-day mortality were uncommon among those undergoing SDD (2.4% and 1.6%) and admission (2.9% and 1.7%), respectively. After controlling for additional factors, SDD after MI-IDS was not associated with 30-day readmissions (adjusted odds ratio (aOR) 0.58, 95% CI 0.14-1.67) nor 90-day mortality (aOR 0.43, 95% CI 0.024-2.07).

Since 2010, a growing proportion of patients have undergone SDD after MI-IDS for advanced ovarian cancer. While SDD was not associated with readmission or postoperative mortality, our small sample size, low event rates, and selection bias limit definitive conclusions.