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  • 2022-RA-1672-ESGO Impact of sepsis on the oncologic outcomes of advanced epithelial ovarian cancer patients: a multicenter retrospective pilot study

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Ovarian cancer
2022-RA-1672-ESGO Impact of sepsis on the oncologic outcomes of advanced epithelial ovarian cancer patients: a multicenter retrospective pilot study
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  1. Sherin Abdo Said1,
  2. Joanne A de Hullu1,
  3. Maaike A van der Aa2,
  4. Ruud LM Bekkers3,
  5. Brigitte FM Slangen4,
  6. Peter Pickkers5 and
  7. Anne M van Altena5
  1. 1Department of Gynecology and Obstetrics, Radboud university medical center, Nijmegen, Netherlands
  2. 2Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
  3. 3Department of Gynecology and Obstetrics, Catharina Hospital, Eindhoven, Netherlands
  4. 4Maastricht University Medical Center, Maastricht, Netherlands
  5. 5Radboud university medical center, Nijmegen, Netherlands

Abstract

Introduction/Background Recently, a case of spontaneous regression of a histologically confirmed FIGO stage IIIC EOC following sepsis was reported. Experimental studies reported that sepsis could induce an antitumor response in other cancers. Studies also shown that the persistent immunosuppression seen in sepsis patients could lead to unfavorable oncologic outcomes of cancer patients. The aim of our pilot study was to assess the impact of sepsis on the oncologic outcomes of advanced stage EOC patients.

Methodology Gynecologic oncologic patients admitted to the Intensive Care Unit (ICU) of three oncologic centers between 01–01–2006 and 01–01–2019 were identified. Patients who experienced sepsis following advanced stage EOC diagnosis or treatment were selected. A descriptive analysis of the impact on the oncologic and survival outcomes of the advanced stage EOC patients was conducted. In addition, differences in survival outcomes between sepsis patients and advanced stage EOC patients from the Netherlands Cancer Registry (NCR) were assessed using Kaplan-Meier survival curves. To correct for differences in case-mix, propensity score matching (PSM) using 1:3 nearest neighbor matching was conducted in a sensitivity analysis after which survival analysis were repeated. Possible mechanisms of antitumor responses following sepsis were also discussed.

Results A total of 18 advanced stage EOC patients who experienced sepsis were identified. Sepsis patients had similar patients, tumor, and treatment characteristics as the NCR cohort. 3/18 patients died from the complications of sepsis. Most patients who survived sepsis developed recurrent EOC at different time-periods. The median OS in months was 31 months for the sepsis cohort and 36 months for the unmatched NCR cohort. The median PFS was 16 months for both cohorts. Similarly, PSM of the two groups did not reveal differences between survival outcomes.

Conclusion Sepsis does not seem to have a positive impact on oncologic and survival outcomes of advanced stage EOC patients.

https://doi.org/10.1136/ijgc-2022-ESGO.771

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