Introduction/Background The ESGO-quality indicators (QIs) for advanced ovarian cancer (AOC) have been assessed only by few Italian centres, and data are not available on the proportion of centres reaching the score considered for a satisfactory surgical management. There is great consensus that the ERAS approach is beneficial, but there is paucity of data concerning its application in AOC. This survey was aimed at gathering detailed information on perioperative management of AOC patients within MITO-MaNGO Groups.

Methodology A 66-item questionnaire, covering ESGO-QIs for AOC and ERAS items, was sent to MITO/MaNGO centres reporting to operate >20 AOC/year.

Results Thirty/34 questionnaires were analysed. The median ESGO-QIs score was 31.5, with 50% of centres resulting with a score ≥32 which provides satisfactory surgical management. The rates of concordance with ERAS guidelines were 46.6%, 74.1%, and 60.7%, respectively, for pre-operative, intra-operative, and post-operative items. The proportion of overall agreement was 61.3%, and with strong recommendations was 63.1%. Pre-operative diet, fasting/bowel preparation, correction of anaemia, post-operative feeding and early mobilization were the most controversial. A significant positive correlation was found between ESGO-QIs score and adherence to ERAS recommendations.

Conclusion This survey reveals a satisfactory surgical management in only half of the centres, and an at least sufficient adherence to ERAS recommendations. Higher the ESGO-QIs score stronger the adherence to ERAS recommendations, underlining the correlations between case volume, appropriate peri-operative management and quality of surgery.