Objective: To evaluate the postoperative complications and their impacts on the patients who have performed with primary cytoreduction (including extra upper abdominal surgery, EUAS) of advanced epithelial ovarian cancer at stage IIIc and IV. Methods: We identified all patients who received primary cytoreduction including EUAS for advanced epithelial ovarian cancer at stage IIIc and IV between September 2017 and March 2019 in our hospital. Postoperative complications were evaluated and graded according to Clavien–Dindo Classification of Surgical Complications. Results: Forty-seven patients were included. There were 40 upper abdominal procedures performed on 22 (46.81%) patients, and 45 cases (95.74%) of patients achieved optimal tumor reduction. The mean postoperative hospital stay was 21.32±12.97 days, and the interval of initial postoperative chemotherapy was 19.41±11.31 days. Thirteen patients reported grade 3-5 complication, and wound abnormal healing was the most common grade 3-5 complications, occurred in 14.89% of patients. 3 cases with mesh repairment and 2 cases with right cardio-phrenic angle lymph nodes removal in the 7 patients with diaphragm resection were without complications. 2 anastomosis leakage at grade B were found in the total colon resection patients, and were recovered by drainage and rinsing. Two patients died of infectious shock and one patient died of disseminated intravascular coagulation (DIC). Univariate analysis identified American Society of Appraisers (ASA) class (P=0.038) and estimated blood loss (p=0.014) were associated with overall complications. Conclusions: Extensive procedures should be cautious for those patients with high ASA score; and MDT team should also be managed on surgical training, experience and risk tolerance
