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470 Uninterrupted excellence: evaluating cytoreduction outcomes for advanced ovarian cancer amidst the COVID era at an ESGO centre of excellence
  1. Konstantinos Kitsos1,
  2. Konstantinos Pitsikakis1,
  3. Marios Evangelos Mamalis2,
  4. Evangelos Kalampokis2,
  5. Yong Sheng Tan1,
  6. Ganiy Abdulrahman1,
  7. Michela Quaranta1,
  8. Amudha Thangavelu1,
  9. Richard Hutson1,
  10. Timothy Broadhead1,
  11. David Nugent1,
  12. Diederick Dejong1 and
  13. Alexandros Laios1
  1. 1Department of Gynaecologic Oncology, ESGO Centre of Excellence for ovarian cancer surgery, St James’s University Hospital, Leeds, UK
  2. 2Information Systems Lab, Department of Business Administration, University of Macedonia, Thessaloniki, Greece


Introduction/Background The COVID-19 pandemic posed unprecedented challenges on the delivery of ovarian cancer care. Hospital resources for COVID-19 patients were prioritized resulting in surgical management plan deviations including delayed or postponed surgeries and increased use of chemotherapy. We aimed to explore the impact of COVID-19 on advanced epithelial ovarian cancer (EOC) surgery.

Methodology Analysing retrospective data from 292 patients with advanced EOC who underwent cytoreductive surgery at a UK tertiary centre, we compared outcomes between pre-COVID (2018–2019) (n=162) and COVID era (2020–2021) (n=130) cohorts for the same timeframe (March to December). We employed Principal Component Analysis (PCA) to quantify the maximum amount of data discrimination between the two cohorts. The outcomes of interest were residual disease (RD) and progression-free-survival (PFS).

Results Two Principal Components were identified that could explain only 0.144 of the data variances due to significant overlap (figure 1). Complete cytoreduction rates remained comparable at 75.93% and 71.54% for pre-COVID and COVID groups, respectively. No statistical differences were found in age (P:0.286), histology (P:0.884), grade (P:0.516), FIGO stage (0.658), cytoreductive rates (P:0.475), ICU admissions (P:0.108), estimated blood loss (P:0.822), pre-surgery CA-125 values (P:0.393), length of stay (P:0.89), and adjuvant chemotherapy (P:0.219) between the two groups. However, distinctions emerged in ECOG performance status (P:0.015) with less interval debulking surgeries (P:0.01), lower surgical complexity scores (P:0.017), and longer operative times in the COVID group (P:0.01) compared to the pre-COVID group. In the pre-Covid group, the median PFS was 35 months (95% CI 33–37). In the Covid group, the median PFS was undefined, but it could be as high as 38 months (P:0.03).

Conclusion We provide early indicators suggesting that management modifications prompted by the COVID-10 pandemic did not adversely impact cytoreduction rates or PFS. Tertiary centres with centralized care systems appeared resilient highlighting the adaptability of modern EOC care strategies during a global health crisis.

Disclosures There are no conflicts of interest.

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