PT  - JOURNAL ARTICLE
AU  - Ghirardi, Valentina
AU  - Marchetti, Claudia
AU  - Ferrante, Maria Giulia
AU  - Faustini, Alice Zampolini
AU  - Scambia, Giovanni
AU  - Fagotti, Anna
TI  - 2022-RA-1470-ESGO Is neoadjuvant chemotherapy effective as prehabilitation program in advanced epithelial ovarian cancer?
AID  - 10.1136/ijgc-2022-ESGO.723
DP  - 2022 Oct 01
TA  - International Journal of Gynecologic Cancer
PG  - A340--A340
VI  - 32
IP  - Suppl 2
4099  - http://ijgc.bmj.com/content/32/Suppl_2/A340.1.short
4100  - http://ijgc.bmj.com/content/32/Suppl_2/A340.1.full
SO  - Int J Gynecol Cancer2022 Oct 01; 32
AB  - Introduction/Background A consistent number of advanced ovarian cancer (AOC) patients present with poor performance status. We sought to determine whether neo-adjuvant chemotherapy(NACT) can modify pre-operative characteristics used to identify patients at high risk(HR) of peri-operative complications, as defined by the Mayo Clinic AlgorithmMethodology In this retrospective single center observational study, FIGO stage III-IV AOC patients undergoing NACT from 01/2016 to 12/2019 were collected and triaged as low risk(LR) and HR according to Mayo Clinic Algorithm. HR group included women with at least one of the following criteria:(i) Albumin <3.5 g/dL,(ii) age ≥80 years,(iii) age 75–79 with ECOG performance status >1, stage IV disease, or complex surgery required and (iv) ASA score ≥ 3. Pre-NACT and post-NACT characteristics were compared in the HR group.Results 177 patients were included, 144(81%) and 33(19%) were classified as HR and LR respectively before NACT. A median number of 4 cycles (range 2–6) of carboplatinum-paclitaxel NACT was administered in HR patients, with bevacizumab addiction in 53% of cases. 115 out of 144 (80%) HR women showed a significant difference in pre-NACT ECOG (p=0.007), ASA score (p=0.001), albumin level(p=0.001) compared to post-NACT setting, taking on LR features. All patients underwent interval surgery and complete cytoreduction was achieved in 97 (84%) cases. Among 42 (35%) post-operative complications, 7(16%) were classified as G3-G4. Median progression free survival was 18 months (CI 95% 14 -21), median overall survival was 54 months (CI 95% 34–73) (figure 1).Abstract 2022-RA-1470-ESGO Figure 1 Progression-free survival and overall survival in HR patientsConclusion NACT appeared to improve pre-treatment patient’s characteristics that may account for an increase peri-operative morbidity. A comparison between the analyzed population and a statistically matched group of HR and LR patients undergoing primary debulking surgery is in due course.