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1108 All wales ovarian cancer prehabilitation project (AWOCPP)
  1. Catherine Ann Smith1,
  2. Josh Courtney Mcmullan1,
  3. Adam Naskretski1,
  4. Rosalind Jones2,
  5. Richard Peevor2,
  6. Caryl Butterworth2,
  7. Kerryn Lutchman-Singh3,
  8. Christine Davies3 and
  9. Sadie Esme Fleur Jones1
  1. 1Cardiff and Vale University Health Board, Cardiff, UK
  2. 2Betsi Cadwaladr University Health Board, Bangor, UK
  3. 3Swansea Bay University Health Board, Swansea, UK


Introduction/Background Over 50% of ovarian cancer patients are diagnosed with advanced disease (stage 3+) in Wales (CRUK); treatment typically involves intense chemotherapy, combined with cytoreductive surgery(Coleridge, Elsherbini, NICE) Surgery of this nature is often complex and extensive with physical and psychological impact on the patient. Patients with advanced ovarian cancer commonly have modifiable risk factors such as poor nutritional status that can be targeted for improvement with personalised prehabilitation (Elsherbini, Dhanis). Multimodal personalised prehabilitation has been shown to have a positive impact on peri-operative outcomes and length of stay in hospital by addressing these modifiable risk factors ( Polen-De, Dholakia, Miriplex).

Methodology Quality improvement methods were used to implement a personalised, multi-modal prehabilitation programme for all advanced ovarian cancer patients planned for surgery in Wales. An assessment determining individual patients modifiable risk factors was devised to create a personalised prehabilitation programme including exercise, nutritional optimisation, smoking cessation, medical optimisation, emotional support, and frailty interventions. The primary outcome measures were length of hospital stay (LOS), post operative complications and surgery to chemotherapy interval. Data were compared to a Welsh historical dataset from 2018–2019 when access to prehabilitation was not available.

Results Following the implementation of prehabilitation for ovarian cancer in Wales the mean LOS reduced from 7.04 to 5.82 days (p = 0.29). Post-operative complications reduced from 16.9% to 12.7% (Grade 2), 4.4% to 1.8% (Grade 3), 0.6% to 0% (Grade 4 + 5). The mean surgery to chemotherapy interval following prehabiliation was 45.79 days compared to 43.79 days (p = 0.65) however, the range reduced from 167 days to 64 days.

Conclusion Personalised, multimodal prehabilitation has had a positive impact on the treatment pathways for advanced ovarian cancer in Wales. Means of improving patient engagement and establishing cost effective delivery need to be developed to make this intervention standard of care across Wales.

Disclosures None.

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