{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:53:07Z","timestamp":1760143987271,"version":"build-2065373602"},"reference-count":52,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Surgery is the cornerstone of ovarian cancer treatment. However, surgery and perioperative inflammation have been described as potentially pro-metastagenic. In various animal models and other human cancers, intraoperative administration of non-steroidal anti-inflammatory drugs (NSAIDs) appears to have a positive impact on patient outcomes. Materials and methods: In this unicentric retrospective study, we provide an exploratory analysis of the safety and potential benefit of intraoperative administration of ketorolac on the outcome of patients undergoing surgery for ovarian cancer. The study population included all patients who were given a diagnosis of ovarian, fallopian tube or peritoneal cancer by the multidisciplinary oncology committee (MOC) of the Cliniques universitaires Saint-Luc between 2015 and 2020. Results: We included 166 patients in our analyses, with a median follow-up of 21.8 months. Both progression-free survival and overall survival were superior in patients who received an intraoperative injection of ketorolac (34.4 months of progression-free survival in the ketorolac group versus 21.5 months in the non-ketorolac group (p = 0.002), and median overall survival was not reached in either group but there was significantly higher survival in the ketorolac group (p = 0.004)). We also performed subgroup analyses to minimise bias due to imbalance between groups on factors that could influence patient survival, and the group of patients receiving ketorolac systematically showed a better outcome. Uni- and multivariate analyses confirmed that administration of ketorolac intraoperatively was associated with better progression-free survival (HR = 0.47 on univariate analysis and 0.43 on multivariate analysis, p = 0.003 and 0.023, respectively). In terms of complications, there were no differences between the two groups, either intraoperatively or postoperatively. Conclusion: Our study has shown a favourable association between the use of ketorolac during surgery and the postoperative progression of ovarian cancer in a group of 166 patients, without any rise in intra- or postoperative complications. These encouraging results point to the need for a prospective study to confirm the benefit of intraoperative administration of ketorolac in ovarian cancer surgery.<\/jats:p>","DOI":"10.3390\/jcm13061546","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T11:33:06Z","timestamp":1709811186000},"page":"1546","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative Ketorolac and Outcomes after Ovarian Cancer Surgery"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3687-3001","authenticated-orcid":false,"given":"Mathieu","family":"Luyckx","sequence":"first","affiliation":[{"name":"UNGO (UCLouvain Network of Gynaecological Oncology), 1200 Brussel, Belgium"},{"name":"Gynaecological Oncology Board, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium"},{"name":"TILS Group, De Duve Institute, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6608-1059","authenticated-orcid":false,"given":"C\u00e9line","family":"Verougstraete","sequence":"additional","affiliation":[{"name":"Gynaecological Oncology Board, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathieu","family":"Jouret","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Centre Hospitaliser de Wallonie Picard (CHWaPi), 7500 Tournai, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiswendsida","family":"Sawadogo","sequence":"additional","affiliation":[{"name":"Statistical Support Unit, Cliniques Universitaire Saint-Luc, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Waterkeyn","sequence":"additional","affiliation":[{"name":"UNGO (UCLouvain Network of Gynaecological Oncology), 1200 Brussel, Belgium"},{"name":"Obstetrics and Gynecology Department, Cliniques de l\u2019Europe, St. Elisabeth Branch, 1180 Brussel, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Grandjean","sequence":"additional","affiliation":[{"name":"UNGO (UCLouvain Network of Gynaecological Oncology), 1200 Brussel, Belgium"},{"name":"Obstetrics and Gynecology Department, Cliniques de l\u2019Europe, St. Michel Branch, 1040 Brussel, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Paul","family":"Van Gossum","sequence":"additional","affiliation":[{"name":"UNGO (UCLouvain Network of Gynaecological Oncology), 1200 Brussel, Belgium"},{"name":"Obstetrics and Gynecology Department, Clinique St-Jean, 1000 Brussel, 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Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascale","family":"Grandjean","sequence":"additional","affiliation":[{"name":"UNGO (UCLouvain Network of Gynaecological Oncology), 1200 Brussel, Belgium"},{"name":"Obstetrics and Gynecology Department, Centre Hospitalier R\u00e9gional, 7000 Mons, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascale","family":"Jadoul","sequence":"additional","affiliation":[{"name":"Gynaecological Oncology Board, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Maillard","sequence":"additional","affiliation":[{"name":"Gynaecological Oncology Board, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amandine","family":"Gerday","sequence":"additional","affiliation":[{"name":"Gynaecological Oncology Board, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6026-1734","authenticated-orcid":false,"given":"Audrey","family":"Dieu","sequence":"additional","affiliation":[{"name":"Anesthesiology Department, Cliniques Universitaire Saint-Luc, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5772-8439","authenticated-orcid":false,"given":"Patrice","family":"Forget","sequence":"additional","affiliation":[{"name":"Epidemiology Group, Department of Anaesthesia, School of Medicine, Medical Sciences and Nutrition, Institute of Applied Health Sciences, University of Aberdeen, NHS Grampian, Aberdeen AB24 3UE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Fran\u00e7ois","family":"Baurain","sequence":"additional","affiliation":[{"name":"UNGO (UCLouvain Network of Gynaecological Oncology), 1200 Brussel, Belgium"},{"name":"Gynaecological Oncology Board, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium"},{"name":"Medical Oncology Department, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Luc","family":"Squifflet","sequence":"additional","affiliation":[{"name":"UNGO (UCLouvain Network of Gynaecological Oncology), 1200 Brussel, Belgium"},{"name":"Gynaecological Oncology Board, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, 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