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588 Neoadjuvant chemotherapy or first line debulking surgery in advanced ovarian cancers
  1. Chemseddine Chekman1,
  2. Fatiha Gouaref2,
  3. Kamel Bentabak2,
  4. Fatiha Hadjarrab3 and
  5. Kamel Bouzid3
  1. 12,Rue Mahmoud Zani Scala Elbiar
  2. 2Cpmc Hospital; Surgery
  3. 3Cpmc Hospital; Medical Oncology


Introduction/Background To evaluate the infra-millimetric resectability rate using the two approaches, the morbidity- mortality rate and the overall survival curves without recurrence.

Methodology From January 2015 to December 2017, 82 patients with ovarian cancer classified stage IIIC by FIGO (International Federation of Gynecologists and Obstetricians), were treated in the oncological surgery department of the CPMC (Center Pierre et Marie Curie), randomized into two groups. First group (G1) including patients who underwent primary debulking surgery and group 2 (G2), patients who underwent primary chemotherapy with platinum salt followed by cytoreductive surgery (interval surgery).

The anatomo-clinical aspect, the histological type, the intraoperative finding, the procedures performed, the results after surgery, the morbidity and mortality and the survival curves were analysed prospectively.

Results The mean age of patients in G1 was 50.05 years (30–80) and in G2 55.90 years (23–80), the majority of patients were classified ASA I in both groups (51, 2%), the mean body mass index (BMI) was 29.16 in the G1 and 27.29 in the G2, the most frequent histological type was serous carcinoma in both groups (69.5%) of patients. The main procedure performed is a total hysterectomy, bilateral adnexectomy, infra colic or infra gastric omentectomy, pelvic and lumbar aortic dissection and resection of any macroscopically visible lesion.

In some cases, an associated procedure has been performed such as digestive resection, cholecystectomy, peritonectomy, caudal pancreatectomy. Rate of actions performed in G1: 65.8%; G2: 34.1%. Rate of R0 obtained (41.4%) or 51.5% in G1 and 48.4% in G2. The operative morbidity was 20.7% with a rate of 14.6% in G1 and 6% in G2.

Conclusion Complete cytoreductive surgery has become a fundamental principle in surgery for peritoneal carcinomatosis. The gold standard for treating advanced ovarian cancer is complete surgery combined with chemotherapy with platinum salt. The sequence of treatment is still debated, but primary surgery seems to be preferred in terms of recurrence-free survival and overall survival when complete resection (R0) is obtained.

Disclosures Pr Chemseddine CHEKMAN: I declare that I have no conflict of interest.

Dr Fatiha GOUAREF: I declare that I have no conflict of interest.

Pr Kamel BENTABAK: I declare that I have no conflict of interest.

Pr Fatiha HADJARRAB: I declare that I have no conflict of interest.

Pr Kamel BOUZID: I declare that I have no conflict of interest.

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