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O041/#768 Mirrors study: a prospective cohort study assessing the feasibility of robotic interval cytoreductive surgery for advanced-stage ovarian cancer
  1. Christina Uwins1,
  2. James Read2,
  3. Anil Tailor1,
  4. James Crawshaw3,
  5. Jayanta Chatterjee1,
  6. Patricia Ellis1,
  7. Simon Skene4,
  8. Agnieszka Michael5 and
  9. Simon Butler-Manuel1
  1. 1Royal Surrey NHS Foundation Trust, Academic Department of Gynaecolgical Oncology, Guildford, UK
  2. 2Royal Surrey NHS Foundation Trust, Department of Colorectal Surgery, Guildford, UK
  3. 3Royal Surrey NHS Foundation Trust, Department of Radiology, Guildford, UK
  4. 4University of Surrey, Surrey Clinical Trials Unit, University of Surrey, Guildford, UK
  5. 5University of Surrey, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK


Objectives MIRRORS (Minimally Invasive Robotic surgery, Role in optimal debulking Ovarian cancer, Recovery & Survival) is the largest prospective cohort study of robotic interval CRS in women with advanced-stage epithelial ovarian cancer to date. MIRRORS has investigated the feasibility of consenting, the acceptability and success of robotic interval CRS and its impact on short-term surgical outcomes and quality of life. Aim: to establish the feasibility and safety of a proposed randomised controlled trial (RCT) of robotic interval cytoreductive surgery (CRS) for advanced ovarian, fallopian tube and peritoneal cancer (EOC) using MIRRORS-protocol.

Methods Eligibility: Women with Stage IIIc-IVb EOC undergoing neoadjuvant chemotherapy, suitable for interval CRS with a pelvic mass ≤8 cm. Robot-assisted laparoscopic assessment proceeding to robotic/open interval CRS (MIRRORS protocol). 6-month post-op surveillance.

Recruitment 23/24 eligible women(95.83%). Following MIRRORS-protocol, completed 20 robotic, 3 open interval CRS. All patients achieved CRS to R<1, robotic: R0 =47.4%, open R0 =0.0%. Conversion rate to open: 0.0%. Median estimated blood loss robotic: 50 ml, open: 2026 ml; length of stay 1.5 days robotic vs 6 days open, time to chemotherapy robotic: 18.5 days vs open: 25 days. 6 month OS and PFS are non-inferior compared with concurrent and retrospective control groups.

Conclusions Robotic interval CRS is safe and feasible in women with a pelvic mass up to 8 cm. A prospective RCT is required to assess whether patients undergoing MIRRORS-protocol have non-inferior overall-survival compared to open interval CRS.

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