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Ovarian Cancer
IGCS19-0134
299 Precision oncology in surgery: patient selection for operable recurrent hepatic ovarian cancer
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  1. V Gallotta1,
  2. C Conte1,
  3. M D’Indinosante2,
  4. E Capoluongo3,
  5. M Angelo4,
  6. A De Rose Maria5,
  7. F Ardito5,
  8. F Giuliante6,
  9. A Di Giorgio7,
  10. GF Zannoni8,
  11. C Margreiter9,
  12. G Scambia10 and
  13. G Ferrandina11
  1. 1Fondazione ‘Policlinico Universitario A. Gemelli’- IRCCS, Department of Women’s and Children’s Health, Rome, Italy
  2. 2Catholic University of the Sacred Heart, Department of Women’s and Children’s Health, Rome, Italy
  3. 3Fondazione ‘Policlinico Universitario A. Gemelli’- IRCCS- Università Cattolica del Sacro Cuore, Dipartimento di Diagnostica di Laboratorio, Rome, Italy
  4. 4Fondazione ‘Policlinico Universitario A. Gemelli’- IRCCS, Dipartimento di Diagnostica di Laboratorio, Rome, Italy
  5. 5Fondazione ‘Policlinico Universitario A. Gemelli’- IRCCS, Department of Surgical Sciences- Hepatobiliary Unit, Rome, Italy
  6. 6Fondazione ‘Policlinico Universitario A. Gemelli’- IRCCS- Catholic University of the Sacred Heart, Department of Surgical Sciences- Hepatobiliary Unit-, Rome, Italy
  7. 7Fondazione ‘Policlinico Universitario A. Gemelli’- IRCCS, Division of General Surgery, Rome, Italy
  8. 8Fondazione ‘Policlinico Universitario A. Gemelli’- IRCCS- Università Cattolica del Sacro Cuore, Instituto di Istopatologia-, Rome, Italy
  9. 9Medical University of Innsbruck, Department of Visceral- Transplant- and Thoracic Surgery-, Innsbruck, Austria
  10. 10Fondazione ‘Policlinico Universitario A. Gemelli’- IRCCS- Università Cattolica del Sacro Cuore, Division of Gynecologic Oncology, Rome, Italy
  11. 11Fondazione ‘Policlinico Universitario A. Gemelli’- IRCCS- Università Cattolica del Sacro Cuore, Division of Gynecologic Oncology-, Rome, Italy

Abstract

Objectives To describe accurately the oncological outcomes after hepatic resection (HR) in recurrent ovarian carcinoma (ROC) evaluating clinic-pathological variables and mutational status of BRCA1/2. Although HR is considered a challenging situation in ROC patients, assessment of BRCA1/2 mutational status seems to have a relevant clinical value to guide surgical therapy.

Methods Patients who underwent HR for ROC at the Catholic University of Rome, between June 2012 and October 2017 were included. Exclusion criteria were represented by extra-abdominal disease and presence of diffuse peritoneal carcinomatosis requiring more than 2 bowel resections. Details relative to HR were collected and BRCA analysis was performed. Predictive factors for of post-relapse progression free survival (PHR-PFS)were assessed by univariate analyses using Cox-proportional hazard regression models.

Results Thirty-four patients undewent HR within secondary cytoreductive surgery (SCS). Six patients (17.6%) presented with hepatic relapse only, while the remaining 28 patients (82.4%) had concomitant extra-hepatic disease. In the whole series, the 3-yr PHR-PFS was 49.1% and the 3-yr progression free survival overall survivalwas 72.9%. Univariate analysis of variables conditioning PHR-PFS showed that only BRCA mutational status played a statistically significant favourable role: the 3-yr PHR-PFS rate was 81.0% in BRCA mutated patient compared to15.2% in wild type ones (p value: 0.001).

Conclusions Our clinical analyses suggest that in ROC patients with liver disease the assessment of BRCA mutational status can help to select patients elegible for SCS.

https://doi.org/10.1136/ijgc-2019-IGCS.299

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