卵巣がん進行期に対する低侵襲間欠的腫瘍核出術後の同日退院

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.