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2022-RA-703-ESGO Primary and interval debulking surgery in advanced ovarian cancer: real-world clinical outcomes of patients in 1st line setting, analysis from the french national ESME-unicancer database
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  1. Hélène Costaz1,
  2. Amal Boussere2,
  3. Quentin Dominique Thomas3,
  4. Isabelle Ray-Coquard4,
  5. Christophe Pomel5,
  6. Laurence Gladieff6,
  7. Frédéric Marchal Marchal7,
  8. Enora Laas8,
  9. Roman Rouzier9,
  10. Renaud Sabatier10,
  11. Anne Floquet11,
  12. Thibault de la Motte Rouge12,
  13. Patricia Pautier13,
  14. Eric Leblanc14,
  15. Emmanuel Barranger15,
  16. Thierry Petit16,
  17. Frédéric Fiteni17,
  18. Pierre-Emmanuel Colombo18,
  19. Anne-Laure Martin Martin19 and
  20. Jean-Marc Classe20
  1. 1Department of Surgical Oncology, Centre Georges François Leclerc, Dijon, France
  2. 2Department of Biometry, Institut du Cancer de Montpellier, Montpellier, France
  3. 3Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier, France
  4. 4Department of Medical Oncology, Centre Léon Bérard, Lyon, France
  5. 5Department of Surgical Oncology, Centre Jean Perrin, Clermont-Ferrand, France
  6. 6Department of Medical Oncology, Institut Claudius Régaud IUCT-O, Toulouse, France
  7. 7Department of Surgery, Institut de Cancérologie de Lorraine, Vandoeuvre-Les-Nancy, France
  8. 8Department of Medical Oncology, Institut Curie, Paris, France
  9. 9Department of Surgical Oncology, Centre François Baclesse, Caen, France
  10. 10Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
  11. 11Department of Medical Oncology, Institut Bergonié, Bordeaux, France
  12. 12Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
  13. 13Department of Medical Oncology, Gustave Roussy, Villejuif, France
  14. 14Department of Surgery, Centre Oscar Lambret, Lille, France
  15. 15Department of Surgery, Centre Antoine Lacassagne, Nice, France
  16. 16Department of Medical Oncology, Institut de Cancérologie, Strasbourg, France
  17. 17Department of Medical Oncology, University Hospital of Nîmes. University of Montpellier, UMR UA11 INSERM, IDESP Institut Desbrest d’Epidémiologie et de Santé Publique, Montpellier, France
  18. 18Department of Surgery, Institut du Cancer de Montpellier, Montpellier University, Montpellier, France
  19. 19Unicancer, Health Data and Partnership Department, Paris, France
  20. 20Department of Surgical Oncology, Institut de Cancérologie de l’Ouest Centre René Gauducheau, Saint Herblain, France

Abstract

Introduction/Background Primary cytoreductive surgery is the standard of care for advanced ovarian cancer. This work would like to explore the prognostic according the surgical management in advanced ovarian cancer of a real-world multicentre cohort.

Methodology A non-interventional, retrospective study in patients selected from the Epidemio-Strategy and Medical Economics (ESME) Ovarian Cancer (OC) Data Platform of Unicancer, a multicentre real-life database using a supervised, retrospective data collection process was conducted.

Patients treated with surgery for advanced ovarian cancer between January 01, 2011 and December 31, 2017 in 18 French Comprehensive Cancer Centers (FCCC) were included. The database was locked on January 01, 2020. Propensity scores were performed in population analyses.

Results 1831 female patients with FIGO stage III or IV ovarian cancer at diagnosis underwent surgery, including 879 (48%) primary debulking surgery (PDS) and 952 (52%) interval debulking surgery (IDS).

The median follow-up was 59.2 months CI 95% [57.1–61.7]. The median overall survival (OS) was 90.4 months for PDS, CI95% [79.4–95.3] and 47.8 months for IDS, CI95% [43.3–54.1], HR = 0.48 CI 95% [0.41–0.56], p<0.0001. The median progression-free survival (PFS) was 23.6 months for PDS, CI95% [20.9–26.1] and 14.3 months for IDS, CI95% [13.0–16.0], HR = 0.66 CI95% [0.59–0.75], p<0.0001.

In the multivariate Cox analysis, the covariates treatment strategy (PDS versus IDS) HR = 0.57 CI 95% [0.44–0.74], p<0.0001, and residual tumor after surgery HR = 1.78 CI 95% [1.25–2.53], p<0.0001 remain significant as a PFS prognostic factors. The OS prognostic factors was the covariates treatment strategy (PDS versus IDS) (p<0.002), residual tumor after surgery (p<0.0001), age at diagnosis (p<0.02) and BRCA mutation (p<0.02).

Conclusion Our data of real-world are in line with those reported in clinical trial for patient with advanced ovarian cancer in 1sr line setting with surgical treatment.

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