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EP929 Survival impact of different surgical strategies in advanced stages ovarian cancer. Analysis in a single center and self-criticism of our outcomes
  1. J Molero Vílchez1,2,
  2. E Martínez Lamela1,3,
  3. S Sancho García4 and
  4. E Bancarali Rojnica5
  1. 1Oncologic Gynecology, Hospital Ntra. Sra. del Rosario, Madrid
  2. 2Oncologic Gynecology, Clinica TocoGyn, Alcalá de Henares
  3. 3Obstetrics and Gynecology, Hospital Universitario Infanta Leonor
  4. 4Radiation Oncology, Hospital Universitario Ramón y Cajal
  5. 5Pathology, Jiménez Ayala Institute, Madrid, Spain


Introduction/Background To evaluate the influence of surgical strategy on survival for patients with stage III or IV epithelial ovarian cancer (EOC).

Methodology Retrospective data collection in a single and reference cancer center. Currently the strategies in advanced ovarian cancer are changing. Our purpose was to analyse the Overall Survival (OS) and Disease Free Survival (DFS) comparing the ‘state of the art’ procedures, Primary Debulking Surgery (PDS) and interval surgery after 3–6 cycles of Neoadjuvant Chemotherapy (NAC). Incidentally, we tested the risk factors for recurrence.

Results Median age was 59 years (40–80). Exploratory laparoscopy was performed in 52 patients, 28 underwent PDS and 24 NAC. Median Laparoscopic Predictive Score (Fagotti) was 2.2 (0–6) and 5.8 (2–10) (p=0.00), median Peritoneal Carcinomatosis Index was 12.5 (2–18) y 18.3 (10–24) (p=0.00) and mean of Ca125 prior to surgery was 489 y 949 U/dL (p=0.00) respectively. Pelvic and para-aortic lymphadenectomy was performed in 20 patients during PDS (14 cases with involved nodes, 48%) and 19 patients during interval surgery NAC (in 6 cases with involved nodes, 25%) (p=0.11). The median Surgical Complexity Score (Aletti) was 5 and 6.5 (p=0.21), with 80 and 24 points in the Comprehensive Compilation Index (modified from Clavien-Dindo Classification) for complications respectively (p=0.13). There were not significant differences in the complete resection rate (61 vs 63%, p=0.99), DFS (12 vs 15 months, p=0.80), and 5-years OS (59 vs 25%, p=0.32). Complete surgery were significantly associated with a better OS in univariate analysis (Hazard ratio 3.34 (95% CI, 1.19–9.40, p=0.015).

Conclusion A significative improvement of OS has been observed in relation with complete tumour resection (microscopial residual tumor). In this study, NAC is non-inferior to PDS and is an acceptable standard of treatment of advanced and bulky EOC.

Disclosure Nothing to disclose.

Abstract EP929 Figure 1

Survival outcome after extensive cytoreductive surgery and chemotherapy in advanced stages ovarian c

Abstract EP929 Figure 2

Survival outcome after extensive cytoreductive surgery and chemotherapy in advanced stages ovarian c

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