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58 Multidisciplinary surgical approach to increase complete cytoreduction rates for advanced ovarian cancer in a tertiary gynaecological oncology centre
  1. K Mulligan1,
  2. K Glennon1,
  3. F Donohoe1,
  4. Y O’Brien1,
  5. R Mc Donnell1,
  6. H Bartels1,
  7. C Vermeulen1,
  8. T Walsh1,
  9. C Shields2,
  10. O Mc Cormack3,
  11. J Conneely3,
  12. W Boyd1,
  13. R McVey1,
  14. J Mulsow2 and
  15. D Brennan1
  1. 1Dept of Gynaecological Oncology, UCD School of Medicine, Mater Misericordiae University Hospital, Ireland
  2. 2National Centre for Peritoneal Malignancy, Mater Misericordiae University Hospital, Ireland
  3. 3Dept of Surgery, Mater Misericordiae University Hospital, Dublin 7, Ireland, Ireland


Objective The aim of this paper is to report on changes in complete cytoreduction rates and morbidity following the implementation of a multi-disciplinary surgical team including gynaecological oncologists, colorectal and upper GI surgeons in a tertiary gynaecological oncology unit. In 2017 we implemented a multi-disciplinary surgical team including gynaecological oncologists, colorectal, hepatobiliary and upper GI surgeons to increase gross macroscopic resection rates.

Methods Two cohorts were used. Cohort A was a retrospectively collated cohort from 2006–2015. Cohort B was a prospectively collated cohort of patients initiated in 2017. A multidisciplinary approach to preoperative medical optimisation, intra operative management and postoperative care was implemented in 2017. Patients in cohort B with upper abdominal disease were offered primary cytoreduction ± HIPEC. Prior to 2017 patients with upper abdominal disease received neoadjuvant chemotherapy.

Results This study include 146 patients in cohort A (2006–2015) and 93 patients in cohort B (2017–2019) with stage III/IV ovarian cancer. The overall complete macroscopic resection rate (CC-0) increased from 58.9% in cohort A to 67.7% in cohort B. The rate of primary CRS increased from 38% (55/146) in cohort A to 42% (39/93) in cohort B. The CC-0 rate in those who had primary CRS increased from 49% in Cohort A to 77% in Cohort B. Major morbidity remained stable throughout both study periods.

Abstract 58 Table 1

Comparison of pre – MDT and post – MDT cohorts

Abstract 58 Figure 1

Impact of multidisciplinary surgical team on rates of complete macroscopic resection in advanced ovarian cancer

Conclusions Our data demonstrates that the implementation of multidisciplinary team intraoperative approach and a meticulous approach to preoperative optimisation has resulted in an significant improvement in complete resection rates particularly in women offered primary CRS.

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