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298 Multidisciplinary maximum effort cyto-reductive surgery (MES) for advanced ovarian cancer in leicester: outcomes
  1. A Ismail1,
  2. O Ofinran2,
  3. Q Davies1,
  4. E Moss1,
  5. R Bharathan1,
  6. K Boyle3,
  7. M Thomas3,
  8. D Malde4,
  9. N Bhardwaj4,
  10. E Camacho5 and
  11. S Chattopadhyay1
  1. 1University Hospitals of Leicester NHS Trust, Gynaecological Oncology, Leicester, UK
  2. 2Royal Wolverhampton Hospitals NHS Trust, Gynaecological Oncology, Wolverhampton, UK
  3. 3University Hospitals of Leicester NHS Trust, Colorectal surgery, Leicester, UK
  4. 4University Hospitals of Leicester NHS Trust, Hepatobiliary surgery, Leicester, UK
  5. 5University Hospitals of Leicester NHS Trust, Anaesthesia, Leicester, UK


Objectives It is recognised that adequate debulking in ovarian cancer surgeries does improve the survival rate; In Leicester, we have implemented a structured multidisciplinary surgical approach to offer Maximum effort surgery (MES) to our patients with advanced ovarian cancer. The surgical team includes gynae-oncologists, hepatobiliary/colorectal surgeons, and anaesthetic team. This approach has helped us develop effective skills in extensive complex abdominal surgeries, and optimising the intraoperative decision making, hence improving the outcomes.

Methods A retrospective evaluation of prospectively collected data was performed to assess the surgical outcomes of all consecutive patients who underwent ultra-radical surgery for advanced ovarian cancer, from January 2016 to February 2019.

Results 39 consecutive women had MES. Median age was 65(range 27–86). 19(49%) had PDS and 18(46%) had IDS while 2(5%) had secondary cytoreduction. The majority of the patients were stage IIIC or above (92%) and most were high grade serous histology (85%). The median surgical duration was 297 minutes. Complete cytoreduction with no gross residual disease (GRD) was achieved in 87% of the patients, 8% had GRD <1cm and only 5% had suboptimal cytoreduction. Median blood loss was 800mls. Median length of hospital stay was 9 days. One patient died in the first 28 days post-surgery. The postoperative complications are presented in table 1 using the Clavien-Dindo classification.

Abstract 298 Table 1

Post-operative complications according to The Clavien-Dindo classification

Conclusions Our data favours a multidisciplinary structured MES service for advanced ovarian cancer and this could be a more effective approach than a unidisciplinary approach. It minimises the morbidity, enables the development interdisciplinary surgical skills and improves the quality of surgery.

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