915P - Prognostic value of multidisciplinar gynaecological committe in ovarian cancer patients

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Ovarian Cancer
Bioethics, Legal, and Economic Issues
Presenter Elena García-Martinez
Citation Annals of Oncology (2014) 25 (suppl_4): iv305-iv326. 10.1093/annonc/mdu338
Authors E. García-Martinez, E. Garcia-Garre, T. Garcia-Garcia, V. Vicente, F. Ayala de La Peña
  • Hematology And Medical Oncology Department, University Hospital Morales Meseguer, 30008 - Murcia/ES

Abstract

Aim

An appropriate surgical staging and optimal cytoreduction (no residual disease) is the best treatment in ovarian cancer patients (OCP). Probably multidisciplinar gynaecological committe (MGC) represents an excellent oportunity to improve results of the surgery and the time in treatment intervals. The objectives of this study were: 1. Evaluate different outcomes in the treatment of OCP depending if the treatment had been decided in the setting of MGC or outside. 2. Evaluate the prognostic value of time to surgery or chemotherapy treatment in ovarian cancer.

Methods

We evaluated retrospectively the different treatment outcomes by two types of 190 OCP: A) OCP who had been discusing in our MGC. B) OCP who had been diagnosed outside our hospital and were referred after surgery to our hospital. Also, we defined: “I. Dx-Sy” as the median of days between diagnostic date and surgery day. “I. Sy-On”: the median of days between surgery and the decision to reffer the patient to oncology.”I. Sy-CT”: The median of days between surgery and the first day of chemotherapy.

Results

We included 190 OCP, 37% with stage I-II, 48% stage III and 14% stage IV. 19% of A patients and 36% of B (p = 0,03) were treated with neoadjuvant chemotherapy and surgery. Appropriate surgical staging and cytoreduction were done in 61% of A and 9,5% of B ovarian cancer patients (p = 0,000000). The optimal cytoreductive surgery rate was 51% in A and 29% in B patients (p = 0,004). I Dx-Sy was 19 + 21 days in A and 13 + 28 days in B (p = 0,01). I Sy-On was 13 + 12 days in A and 25 + 44 days in B (p = 0,03). I Sy-CT was 40 + 11 in A and 42 + 13 days in B. Median folow-up was 47 months. Clinical stage HR = 2,4 95%IC (1,1 – 5,1), p = 0,01, type of cytoreduction HR = 5,3 95%IC (1,5 – 17,7), p = 0,007 and I. Sy-CT HR = 3,0 95%IC (1,0 – 8,0) p = 0,04 were independent prognostic factors for disease free survival. Also, clinical stage HR = 2,3; 95%IC (0,9 – 5,7); p = 0,07; type of cytoreduction HR = 8,9; 95%IC (1,9 – 40,7), p = 0,05 and I Sy-CT HR = 5,1 95%IC (1,3 – 19,9), p = 0,01 were independent prognostic factors for overall survival.

Conclusions

Our study reveals the time interval between the surgery and chemotherapy as prognostic factor. The managment of OCP in a MGC is related with higher rates of optimal cytoreduction surgery, adittionally it is related with better time treatment intervals. OCP might be reffered to a MGC

Disclosure

All authors have declared no conflicts of interest.