Postoperative Weight Gain, Due to Fluid Retention After Ovarian Cancer Surgery-How Much Is too Much?

Postoperative complications after cytoreductive surgery in ovarian cancer patients are associated with impaired survival. Here, we investigated the association between postoperative weight gain due to fluid retention and the development of complications and anastomotic leakage (AL).

N = 278 patients underwent cytoreductive surgery at the university hospital of Bonn in between 01/2013 and 03/2022. Postoperative weight gain on day 2 and day 5 was assessed and correlated to the occurrence of complications according to the MSKCC secondary event score and ALs.

There were 227 surgeries (81.7%) for primary and 51 surgeries (18.3%) for recurrent ovarian cancer. Severe complications were significantly more frequent in patients with postoperative weight gain exceeding 4 kg on postoperative day 2 (26/90 vs. 13/76; p = 0.03) and exceeding 3 kg on postoperative day 5 (34/89 vs 30/134; p = 0.02). A weight gain of more than 6 kg on postoperative day 2 was significantly associated with the occurrence of AL (p = 0.021). Less weight gain on d2 and d5 was associated with a significant earlier first defecation (day-2 p-value: 0.01; day-5 p-value: 0.01). In multiple binary logistic regression analysis, the postoperative weight gain on day 2 (p = 0.0019) and the performance of an anastomosis (p = 0.0095) remained the only significant risk factors regarding severe complications.

Postoperative weight gain, as a surrogate for fluid retention, and the creation of an anastomosis were associated with an increased risk of severe postoperative complications.