• R Iyer, A Gentry-Maharaj, A Nordin, M Burnell, R Liston, R Manchanda, N Das, R Desai, R Gornall, A Beardmore-Gray, J Nevin, K Hillaby, S Leeson, A Linder, A Lopes, D Meechan, T Mould, S Varkey, A Olaitan, B Rufford, A Ryan, S Shanbhag, A Thackeray, N Wood, K Reynolds, and U Menon.
• Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, 1st Floor Maple House, 149 Tottenham Court Road, London W1T 7DN, UK.
• Br. J. Cancer. 2015 Feb 3; 112 (3): 475-84.

BackgroundThere are limited data on surgical outcomes in gynaecological oncology. We report on predictors of complications in a multicentre prospective study.MethodsData on surgical procedures and resulting complications were contemporaneously recorded on consented patients in 10 participating UK gynaecological cancer centres. Patients were sent follow-up letters to capture any further complications. Post-operative (Post-op) complications were graded (I-V) in increasing severity using the Clavien-Dindo system. Grade I complications were excluded from the analysis. Univariable and multivariable regression was used to identify predictors of complications using all surgery for intra-operative (Intra-op) and only those with both hospital and patient-reported data for Post-op complications.ResultsProspective data were available on 2948 major operations undertaken between April 2010 and February 2012. Median age was 62 years, with 35% obese and 20.4% ASA grade ⩾3. Consultant gynaecological oncologists performed 74.3% of operations. Intra-op complications were reported in 139 of 2948 and Grade II-V Post-op complications in 379 of 1462 surgeries. The predictors of risk were different for Intra-op and Post-op complications. For Intra-op complications, previous abdominal surgery, metabolic/endocrine disorders (excluding diabetes), surgical complexity and final diagnosis were significant in univariable and multivariable regression (P<0.05), with diabetes only in multivariable regression (P=0.006). For Post-op complications, age, comorbidity status, diabetes, surgical approach, duration of surgery, and final diagnosis were significant in both univariable and multivariable regression (P<0.05).ConclusionsThis multicentre prospective audit benchmarks the considerable morbidity associated with gynaecological oncology surgery. There are significant patient and surgical factors that influence this risk.

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