Article Text
PDF
Abstract
Introduction The participation in surgical RCTs provides known survival benefits to patients. However, it is critical that any such intervention would not alter the surgical decision algorithm to patients detriment. In a tertiary referral centre which has published data demonstrating the clinical benefit to patients OS with a MDT surgical approach to EOC Cytoreductive Surgery(CRS) and has robust pre and intra operative MDT approach we reviewed the Peritoneal Carcinomatosis Index(PCI) and surgical complexity score(SCS) to determine if participation the OVIHIPEC2 trial had impacted on MDT decision making.
Methods A prospectively maintained database was assessed to compare PCI, SCS and post-operative haematological morbidity in pre operatively assessed Stage 3 ovarian cancer comparing two cohorts from pre and post participation in the OVIHIPEC 2 Trial (January 2023) Cohort 1 (n=82) from January 2019 to November 2022 and Cohort 2 November 2023 to April 2024 (n=22).
Results The median PCI and inter quartile range(IQR 25-75%) was similar in both cohorts, 14 (9-19 vs 14 (6-18) NSS (p=0.528).The rate of complete macroscopic resection (CC-0)was similar in both (86% vs 95%) (p=0.565). The median SCS and IQR was also similar in both groups 6 (5-9) vs 6 (4-8)(p=0.603). There was NSS difference in haematological morbidity between the groups with a median (IQR) EBL of 1300 (612-1963) vs 1050 (800-1525)(p=0.870).
Conclusion/Implications While access to international surgical clinical trials is beneficial for patient outcomes a robust MDT input both pre and intra operatively is critical to ensure the decision making paradigm remains consistent.
