Postoperative pleural effusion after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer patients: predictive role of preoperative albumin levels, diaphragmatic disease involvement and preoperative pleural effusion
With great deal of interest, we read the article entitled “Risk factors of pleural effusion (PE) after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in late-stage and recurrent ovarian cancer” by Zhao et al. (1).
The authors present the incidence [57.1% (44/77 patients)] and predisposing parameters of PE after tumour debulking and HIPEC in 77 women with advanced and/or recurrent ovarian carcinoma. They mentioned that preoperative PE is an independent predisposing parameter of postoperative PE with a prevalence of 24%. Moreover, partial diaphragmatic resection was found to be another independent risk factor. Furthermore, although the albumin levels in women with postoperative PE were lower than those in the control group, no statistical significance was identified in the multivariate analysis (1).
We would like to present our findings in a similar cohort of patients of our group. More specifically, our cohort consisted of 257 patients who underwent debulking and HIPEC. The incidence of postoperative PE was 77/257 (29.96%). We also found that both preoperative PE as well as diaphragmatic involvement are independent predisposing parameters of postoperative PE (Table 1). Additionally, both preoperative as well as postoperative albumin levels were found to be lower in postoperative PE in a statistically significant level (Table 1). Finally, age, different histological subtypes and-or bowel involvement were not found to be independent risk factors of postoperative PE (Table 1).
Full table
Our findings confirm the role of preoperative PE, diaphragmatic involvement and furthermore preoperative albumin levels as independent prognostic parameters of postoperative PE in patients with ovarian carcinoma undergoing CRS and HIPEC. A tertiary centre cooperation in the field may further highlight such a role and may help to form a predictive preoperative algorithm of postoperative PE. Once again, we would like to thank the authors for their interesting article.
Acknowledgments
There are no other contributors to the manuscript or any other authors that could qualify for inclusion as authors. The language of the paper was edited by a native English speaker Mr. Jonathan Boyle.
Funding: None.
Footnote
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Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/apm-21-1527). The authors have no conflicts of interest to declare.
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References
- Zhao J, Zhang Y, Yang X, et al. Risk factors of pleural effusion after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in late-stage and recurrent ovarian cancer. Ann Palliat Med 2021;10:385-91. [Crossref] [PubMed]
