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2022-RA-285-ESGO Real world data of treatment and outcome of patients with early ovarian cancer (FIGO I) in Germany (QS Ovar of the AGO Study Group)
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  1. Jalid Sehouli1,
  2. Andreas du Bois2,
  3. Jacobus Pfisterer3,
  4. Felix Hilpert4,
  5. Markus Kerkmann5,
  6. Sven Mahner6,
  7. Nikolaus de Gregorio7,
  8. Lars Ch Hanker8,
  9. Florian Heitz2,
  10. Frederik Marmé9,
  11. Linn Lena Wölber10,4,
  12. Laura Holtmann5,
  13. Sandra Polleis11,
  14. Pauline Wimberger12,
  15. Philipp Harter2 and
  16. AGO Study Group
  1. 1Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Universitätsmedizin Berlin, Charité, Berlin, Germany
  2. 2Klinik für Gynäkologie and Gyn. Onkologie, Ev. Kliniken Essen-Mitte, Essen, Germany
  3. 3Zentrum für Gynäkologische Onkologie, Kiel, Germany
  4. 4Onkologisches Therapiezentrum Krankenhaus Jerusalem, Hamburg, Germany
  5. 5MMF Research GmbH, Münster, Germany
  6. 6Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
  7. 7Frauenklinik, Klinikum am Gesundbrunnen, SLK-Kliniken Heilbronn GmbH, Heilbronn, Germany
  8. 8Universitätsklinikum Schleswig-Holstein, Klinik für Gynäkologie und Geburtshilfe, Campus Lübeck, Lübeck, Germany
  9. 9Universitätsfrauenklinik, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
  10. 10Department of Gynecology; University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  11. 11AGO Study Group, Wiesbaden, Germany
  12. 12Department of Gynecology and Obstetrics, TU Dresden, Dresden, Germany

Abstract

Introduction/Background Recent data regarding treatment quality and outcome of patients with early Ovarian Cancer (FIGO I) on a nationwide basis are largely missing for Germany.

Methodology All German hospitals treating patients with ovarian cancer were asked to document all patients with first diagnosis in the third quarter of the years 2004, 2008, 2012 and 2016. Surgery quality was categorized as ‘optimal’ (OP+: maximum 1 parameter missing), vs ‘suboptimal’ (OP-). Chemotherapy was defined as optimal according to national guidelines. The overall treatment quality was classified in 3 categories: (1) surgery and chemotherapy optimal (OP+/CT+) versus (2) optimal/suboptimal combined (OP+/CT- or OP-/CT+) versus (3) both suboptimal (OP-/CT-).

Results 19.9% (n=700) of all OC patients were diagnosed FIGO I, of which 47.1% were FIGO IA, 47.9% FIGO IC. Median follow-up period was 51.0 months. Median age was 60 years and 37.1% showed high-grade serous ovarian cancer. The OP+ collective increased from 42.2% to 70.9%. Most common not performed surgical steps were peritoneal biopsies, paraaortic and pelvic lymphadenectomy. Progression-free survival (PFS) and overall survival (OS) were improved with OP+ (84% and 91% at 48-months compared with 71% and 76% with non-optimal surgery: both p<0.001). Optimal chemotherapy standard (CT+) was administered increasingly frequent (71.4% to 80.8%). PFS and OS were prolonged with CT+: 48-months PFS 84% vs. 63% (p<0.001) and 48-months OS 90% vs. 68% (p<0.001). The overall treatment quality cohort 1 increased from 37.9% to 54.1%. 48-months PFS was 86% vs. 76% vs. 62% in group 1 vs. 2 vs. 3, respectively (p<0.001), 48-months OS rates were 93% vs. 81% vs. 68% in group 1 vs. 2 vs. 3, respectively (p<0.001).

Conclusion The QS Ovar shows that the quality of therapy has steadily improved over the years in Germany. Best prognosis could be achieved if surgery and chemotherapy is done according to treatment guidelines.

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