Comparison of the outcomes of optimal cytoreductive surgery achieved in stage IIIC serous papillary epithelial ovarian cancer at different centers: is experience important?

Headnote

Keywords: Optimal cytoreduction, ovarian cancer, surgical experience, survival

[OP-123]

Objective: There has been a slight improvement in ovarian cancer survival in parallel to the advances both in surgical techniques and chemotherapeutic regimens; however, five-year survival rate still remains far less than the desired. Survival not only depends on the stage and type of the tumor, but also on the surgical experience, resectability of the tumor, and the ability of patient to tolerate extensive surgery. The aim of the present study was to compare recurrence and survival rates of gynecologic oncology patients, who were operated by experienced gynecologic oncologists, with recurrence and survival rates of patients, who underwent optimal cytoreductive surgery in a center not designated as a specific oncology center.

Material and Methods: The study included 82 patients with FIGO Stage 3C serous papillary ovarian cancer that underwent optimal cytoreductive surgery between 2001 and 2015. The centers were divided into two groups, as designated experienced clinics providing gynecologic oncology training (Group 1) and non-academic centers that do not provide training (Group 2). The study compared surgical parameters, recurrence rates, and overall and disease-free survival rates between the groups.

Results: The median duration of follow-up was 51 months in Group 1 (min: 4 months, max: 113 months) and 46 months in Group 2 (min: 13 months, max: 106 months). Demographic data, operative data and comparisons are provided in table 1. The median disease-free survival was 16 months (1-101 months) in Group 1 and 9 months (4-106 months) in Group 2 (p=0.038). The median overall survival was 51 months (4-113 months) in Group 1 and 35 months (13-106 months) in Group 2 (p=0.017) (Figure 1). During the follow-up period, 19 patients (38.8%) in Group 1 and 27 patients (81.8%) in Group 2 died from disease.

Conclusion: The treatment of ovarian cancer requires a multidisciplinary approach (involving a surgeon, pathologist, medical oncolo- gist, chemotherapy nurse, etc.). Optimal surgery is of particular importance to successful treatment and requires a close collaboration between gynecologic oncologist and surgical oncologist. The results of the current study emphasize the importance of optimal surgery as well as surgical education and experience in the treatment of ovarian cancer.