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333 Impact of extent of cytoreductive surgery (CRS) on survival in epithelial ovarian cancer (EOC), primary peritoneal carcinomatosis (PPC), and fallopian tube cancer (FTC) at the american university of beirut (AUBMC)
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  1. M Seoud1,
  2. A El Housheimi1,
  3. I Jaafar1,
  4. K Hamed1,
  5. F Jamali2,
  6. R Abdallah1 and
  7. A Khalil1
  1. 1American University of Beirut Medical Center, Obstetrics and Gynecology, Beirut, Lebanon
  2. 2American University of Beirut Medical Center, General surgery, Beirut, Lebanon

Abstract

Objectives To study the impact of the extent of CRS [complete Debulking (CD), optimal Debulking (OD)<1cm, or suboptimal Debulking (SOD) >1cm residual disease] on progression free (PFS) and overall survival (OS) in advanced EOC, PPC and FTC treated at AUBMC 1998–2018.

Methods We retrospectively reviewed all patients with advanced disease who underwent either Primary debulking surgery (PDS) or if they had large tumor burden/multiple co-morbidities/poor performance status, they received neoadjuvant chemotherapy and interval debulking surgery (NACT+IDS).

Results Of 300 patients with EOC/PPC/FTC, 220 had advanced stages (IIIB-IV). 66.4% had CD, 29.7% OD and 2.6% SOD. Results are shown in image 1 and tables 2 and 3. Median survival is expressed in months. In stage IIIC, CD led to a significantly higher PFS compared to OD (image 1) (P-value=0.015). However, this increase in PFS was only seen after IDS (table 2) (P-value in IDS=0.009). Once a CD was reached, There was no statistically significant increase in PFS regardless of timing of CRS (Image 3) (Pvalue=0.775). OS was not affected by extent of CRS (Image 1).

Abstract 333 Figure 1

Extent of CRS and PFS and OS in stages IIIC and IV

Abstract 333 Table 1

CD in the primary versus interval setting in stage IIIC

Abstract 333 Table 2

PFS of patients with CD in PDS versus IDS in stage IIIC

Conclusions The extent of CRS significantly prolonged PFS but not OS in stage IIIC but not IV. This increase in PFS is only seen after IDS. Patients having CD have similar PFS and OS regardless of the timing of CRS.

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