Introduction/Background Our goal in ovarian cancer surgery is to deliver optimal treatment aiming at maximal survival benefits. Quantifying radicality and timing of surgery may help to individualise surgical treatment. We assessed the impact of these parameters on progression free survival (PFS) and overall survival (OS).
Methodology Patients with a diagnosis of advanced stage (FIGO IIIC/IV) high grade serous ovarian cancer (HGSOC) who underwent surgical cytoreduction from January 2015 to December 2017 was selected from the ovarian database. We evaluated age, timing of surgery (upfront vs delayed cytoreduction), surgical complexity score (SCS), and residual disease (RD). SCS was assigned based on the Aletti classification as low, intermediate and high. Kaplan Meier curves were constructed for PFS and OS.
Results Eighty patients were identified. Mean age and BMI were 63.5±11 yrs. and 26.6±4.8 respectively. The mean SCS was 3±1 (1–8). Complete and optimal cytoreduction was achieved in 48/80 (58.7%) and 66/80 (82.6%) patients. Median PFS and OS were 17 and 44 months respectively. The presence of RD had a negative impact on PFS: 20, 16, and 12 months for nil macroscopic, <1 cm, and >1 cm, respectively. Although not significant, upfront surgical cytoreduction vs delayed surgical cytoreduction resulted in a better PFS (NS). Patients with a higher surgical complexity score (>3) showed a favourable trend in PFS compared to those with a low surgical complexity score (<3): 25 vs. 16 months, p=0.19 albeit not affecting OS (p=0.57). Younger patients (<75 yrs) are likely to have a better PFS and OS than those >75 yrs (p=0.21 and p=0.07, respectively).
Conclusion We observed trends towards favourable prognosis in patients with upfront surgical cytoreduction, more radical surgery and younger age. No significant differences were observed for OS. This cohort is currently expanding to reach significance.
Disclosure Nothing to disclose.
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