PhD defence M. (Malika) Kengsakul

Below is a brief summary of the dissertation:

This thesis evaluates cytoreductive surgery in primary advanced epithelial ovarian cancer (EOC), with the aim of improving patient selection, minimizing postoperative morbidity, and optimizing surgical outcomes. Integrating evidence from meta-analysis, prospective cohort studies, and validation research, it examines the relationship between preoperative clinical factors, radiologic assessment, intraoperative findings, and postoperative outcomes to support more individualized, evidence-based surgical decision-making.
The findings demonstrate that severe postoperative complications are associated with advanced age, poor performance status, hypoalbuminemia, extensive surgical procedures, and intraoperative injury, with consequent delays in the initiation of adjuvant chemotherapy. Preoperative performance status emerged as the most consistent modifiable risk factor. In addition, the Comprehensive Complication Index was shown to provide a more sensitive assessment of postoperative morbidity compared with conventional classification systems.
Radiologic evaluation using computed tomography showed limited accuracy in predicting surgical resectability, while cardiophrenic lymph node enlargement was identified as an adverse prognostic factor. The findings underscore the need for improved preoperative risk stratification models and standardized reporting systems to enhance patient-centered management and surgical outcomes in advanced EOC.