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Poster/ePoster Sessions
06. Ovarian cancer
#288 Prognostic factors following cytoreductive surgery for advanced epithelial ovarian cancer
Free
  1. Ester Martínez Lamela1,2,
  2. Jesús Molero Vílchez1,3,
  3. Angela santiago Gómez4,
  4. Judith Suarez Aguado5 and
  5. Yolanda Expósito Lucena6
  1. 1Ntra. Sra. del Rosario Universitary Hospital, Madrid, Spain
  2. 2Infanta Leonor University Hospital, Madrid, Spain
  3. 3Toco-Gyn Gynecological Clinic, Alcalá de Henares, Spain
  4. 4Advance Tecniques Cancer Center (ITACC), Madrid, Spain
  5. 5Jiménez Ayala Institute, Madrid, Spain
  6. 6Toco-Gyn Gynecological Clinic, Madrid, Spain

Abstract

Introduction/Background To examine the association between clinicopathological factors and survival in advanced epithelial ovarian, tubal, and primary peritoneal cancers patients (stages III-IV FIGO 2017) who had primary cytoreductive surgery (PDS) and those that received neoadjuvant platinum-based chemotherapy (NAC) followed by interval debulking surgery (IDS).

Methodology 75 women were recruited in this study who had PDS or IDS between January 2008-March 2023. Association between clinical characteristics, pretreatment imaging, serum markers, surgical and pathological factors, and disease recurrence and overall survival was examined in univariable and multivariable analysis (Kaplan-Meier and Cox proportional hazard model).

Results 47 women (PDS) and 28 (IDS) women were included. No residual tumor (R0) was in 72.3% of patients after PDS and in 57.2% of patients after IDS. Postoperative rates of adverse effects and mortality were higher after PDS than after IDS (p=0.793). Median overall survival was not reached for the PDS group and 78 months for the IDS group (p=0.292). Median progression-free survival was 60 months in the PDS group and 52 months in the IDS group (p=0.04). Factors in multivariable analysis associated with increased risk of recurrence included primary peritoneal carcinoma (hazard ratio HR: 6.09, 95% CI 1.55–23.87, p= 0.01), residual tumor >1cm (HR: 2.72, 95% CI 1.06–6.98, p= 0.037) and stable/progression in response to chemotherapy (HR 8.85, 95% CI 1.76–44.45, p= 0.008).

Conclusion PDS before chemotherapy is the standard of care for patients with advanced ovarian cancer. NAC appeared to be a good option when the PDS is not likely as a first choice. The worse survival outcome was associated with primary peritoneal carcinoma, residual tumor in surgical status and a bad response to chemotherapy.

Abstract #288 Figure 1
Abstract #288 Figure 1

Disclosures Factors independently associated with increased risk of death included residual tumor>1 cm (HR: 4.52, 95% CI 1.86–11.02, p= 0.001) and stable disease/progression at chemotherapy (HR: 13.42, 95% CI 2.7–66.57, p= 0.001)

https://doi.org/10.1136/ijgc-2023-ESGO.554

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