PT  - JOURNAL ARTICLE
AU  - I Mulder
AU  - N Fleming
AU  - C Sun
AU  - B Fellman
AU  - L Ulin
AU  - M Ozer
AU  - R Coleman
AU  - P Ramirez
AU  - K Rangel
AU  - P Soliman
AU  - A Nick
AU  - K Lu
AU  - A Sood
AU  - S Westin
TI  - 398 Impact of a laparoscopic triage program for advanced ovarian cancer on surgical outcomes, disease-free survival, and overall survival
AID  - 10.1136/ijgc-2020-IGCS.344
DP  - 2020 Nov 01
TA  - International Journal of Gynecologic Cancer
PG  - A165--A165
VI  - 30
IP  - Suppl 3
4099  - http://ijgc.bmj.com/content/30/Suppl_3/A165.1.short
4100  - http://ijgc.bmj.com/content/30/Suppl_3/A165.1.full
SO  - Int J Gynecol Cancer2020 Nov 01; 30
AB  - Introduction This study evaluates whether implementing a laparoscopic triage algorithm (LSC) to grade initial disease burden impacts surgical outcomes, disease-free survival (DFS), and overall survival (OS) in advanced ovarian cancer (OC).Methods In 2013, LSC was implemented for advanced high-grade serous OC. LSC scores volume and distribution of intra-abdominal disease in order to disposition patients to either primary cytoreductive surgery (PDS) or neoadjuvant chemotherapy (NACT) followed by interval cytoreduction. Outcomes for patients offered management with LSC (post-LSC) were compared to a cohort from 2010–2012 who would have qualified for laparoscopy (pre-LSC). Summary statistics were used to describe surgical outcomes, and DFS and OS were estimated using the Kaplan-Meier method.Results Between 2013–2016, 201 OC patients were offered LSC; 182 underwent laparoscopy. We identified 161 pre-LSC control patients for comparison. There were no differences in clinicodemographic features between both cohorts. Prior to implementing LSC, 64 (40%) patients underwent PDS compared to 88 (44%) post-LSC (p=0.42). Complete cytoreduction (R0) was achieved more frequently in the post-LSC cohort (81 vs 51%, p<0.001). There were no differences in median DFS or OS between pre- and post-LSC cohorts (DFS 17 vs 16 months, p=0.76; OS 45 vs 48 months, p=0.38). However, within the PDS group, a significantly greater median OS was observed in post-LSC compared to pre-LSC cohort (not reached vs 51 months, p<0.013).Conclusion Our data suggest that LSC allows for a greater R0 resection rate and, for patients triaged to PDS, is associated with improved median OS.