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374 Low anterior resection symptoms are more frequent and severe following interval compared to primary cytoreductive surgery for ovarian cancer
  1. Lesley Sheach1,
  2. Radha Graham1,
  3. Shania Makker2,
  4. Nicola Macdonald1 and
  5. Ioannis Kotsopoulos1,3
  1. 1University College London Hospital, London, UK
  2. 2University College of London, Cancer Institute, London, UK
  3. 3Women’s Cancer, EGA Institute for Women’s Health, University College London, London, UK

Abstract

Introduction/Background Low anterior resection is the most common bowel resection performed during cytoreductive surgery for ovarian cancer. In the colorectal patient population, bowel dysfunction, described as Low Anterior Resection Symptoms (LARS), is common, and a standardized questionnaire is used to quantify these. LARS have been studied less frequently in the ovarian cancer patient population but have been shown to correlate with Quality of Life (QoL) scores.

Methodology At University College London Hospital (UCLH), we retrospectively identified 68 patients who had a low anterior resection as part of primary (pCRS) or interval cytoreductive surgery (iCRS) between 2018 and 2023. 32 of these patients were alive at the time of study and completed a standardized LARS questionnaire. Based on the questionnaire score, patients were classified as either having ‘no’, ‘minor’ or ‘major’ LARS.

Results Of the patients questioned, 62% reported LARS post-operatively, with approximately 40% having major LARS. This is in keeping with rates reported elsewhere. We found a significantly higher frequency (72 v 52%, p=0.01) and severity (58 v 29% major LARS p=0.003) of LARS in patients who had interval compared to primary cytoreductive surgery. Of note, there was no signficant difference in patient age or surgical complexity between the pCRS and iCRS groups. In addition, we found that the standardized LARS questionnaire was a more sensitive tool for detecting symptoms compared to ad-hoc questioning.

Conclusion Following anterior resection during cytoreductive surgery for ovarian cancer, a high proportion of patients reported LARS. Patients undergoing interval surgery appear to be at higher risk. A larger, prospective study, with pre-operative symptom profiling is now proposed . However, from our data, we argue that LARS should be discussed pre-operatively, the LARS questionnaire should be incorporated into routine follow up and, when identified, a standardized pathway to treat LARS should be available to clinicians.

Disclosures N/A

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