Introduction/Background Adnexal carcinoma is most often diagnosed at an advanced stage and the standard treatment is chemotherapy combined with cytoreductive surgery (CRS). This CRS must be macroscopically complete and, because of the possible need for extensive resections, may be a source of postoperative complications. A score has been described specifically for advanced ovarian cancer (AOC) surgery, the surgical complexity score (SCS) from 1 to 18. It defines 3 groups according to the resection procedures performed: low risk (SCS ⩽ 3), intermediate risk (SCS between 4 and 7), or at high risk (SCS ⩾ 8) of presenting a complication of grades III to V of the Clavien-Dindo classification.

Methodology Between 2017 and 2022, 239 CRS are performed for AOC at the Oscar Lambret Center. Different disease variables, patient comorbidities, and complications during the 30-day postoperative period were collated. Descriptive statistical analyses and correlation test were used and the association between the risk of serious complications and SCS was explored with a logistic regression model.

Results The CRS was classified as low risk for 35 patients (14.6%), intermediate risk for 110 patients (46%), and high risk for 94 patients (39.3%). Within 30 days after surgery, 254 patients (10%) had a Clavien-Dindo grade III to V complication. The serious complication rate in our cohort was 7.6% among patients with SCS < 8 versus 13.8% in the group of patients with SCS ≥ 8. Compared to patients with SCS < 8, patients with SCS ≥ 8 had a higher, but not significant, risk of complications (OR=1.96 [0.84- 4.57], p=0.12).

Conclusion In our cohort, an SCS ≥ 8 is in favor of a higher risk of serious postoperative complication. The use of this score in CRS could help to propose tailored perioperative management based on SCS.

Disclosures none disclosures