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Mini Oral - Gynaecological cancers 2

816MO - AGO DESKTOP III/ENGOT OV20: Impact of surgical characteristics and time to first subsequent therapy (TFST)


18 Sep 2020


Mini Oral - Gynaecological cancers 2


Surgical Oncology

Tumour Site

Ovarian Cancer


Fabrice Lecuru


Annals of Oncology (2020) 31 (suppl_4): S551-S589. 10.1016/annonc/annonc276


F. Lecuru1, A. du Bois2, J. Sehouli3, I.B. Vergote4, G. Ferron5, A. Reuss6, W. Meier7, S. Greggi8, P. Jensen9, F. Selle10, F. Guyon11, C. Pomel12, R. Zang13, E.H. Avall-Lundqvist14, J. Kim15, J. Ponce16, F. Raspagliesi17, G. Sadaf18, A. Reinthaller19, P. Harter20

Author affiliations

  • 1 Breast, Gynecology And Reconstructive Surgery Unit, GINECO & Curie Institute, 75005 - Paris/FR
  • 2 Department Of Gynecology & Gyn.oncology, Kliniken Essen Mitte Evang. Huyssens-Stiftung, 45136 - Essen/DE
  • 3 Department Of Gynaecology, NOGGO and Charité Campus Virchow-Klinikum, 13353 - Berlin/DE
  • 4 Department Of Gynecology, BGOG and University Hospitals Leuven, Leuven Cancer Institute, 3000 - Leuven/BE
  • 5 Département De Gynécologie Oncologique, GINECO and Institut Claudius Regaud, 31059 - Toulouse/FR
  • 6 Coordinating Center For Clinical Trials, AGO & Coordinating Center for Clinical Trials, Philipps-University of Marburg, 35043 - Marburg/DE
  • 7 Department Of Gynecology, AGO and Frauenklinik, Evangelisches Krankenhaus Duesseldorf, 40217 - Duesseldorf/DE
  • 8 Department Of Gynecology, MITO & Gynecologic Oncology, Instituto Tumori Fondazione G. Pascale, 80131 - Napoli/IT
  • 9 Department Of Gynecology, NSGO and Odense University Hospital, 5000 - Odense/DK
  • 10 Department Of Oncology, Hôpital Tenon, 75020 - Paris/FR
  • 11 Department Of Gynecology, GINECO & Institut Bergonie, 33076 - Bordeaux/FR
  • 12 Department Of Gynecology, GINECO and Centre Jean Perrin, 63011 - Clermont-Ferrand/FR
  • 13 Department Of Obstetrics And Gynecology, SGOG and Shanghai Fudan University, Shangai/CN
  • 14 Oncology, Clinical And Experimental Medicine Department, NSGO & Linköping University and Karolinska Institute, 581 83 - Linkoping/SE
  • 15 Obstetrics Adn Gynecology, KGOG & Seoul National University, Seoul/KR
  • 16 Department Of Gynecology, GEICO and Bellvitge Hospital Feixa Llarga s/n, Barcelona/ES
  • 17 Department Of Gyn. Oncology, MITO & Fondazione IRCCS Istituto Nazionale Tumori VIA VENEZIAN 1, 20133 - Milan/IT
  • 18 Department Of Gynaecological Cancer, Gynaecology, Maternity And Obstetrics, NCRI and Imperial College London IRDB, The Hammersmith Hospital, Du Cane Road, London/GB
  • 19 Gynecology And Obstetrics, AGO-Austria and University of Vienna, Vienna/AT
  • 20 Gynecology & Gynecologic Oncology, AGO & Ev. Kliniken Essen-Mitte (PI), 45136 - Essen/DE


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Abstract 816MO


DESKTOP III has shown a significant benefit regarding PFS and OS in favor of patients with secondary cytoreductive surgery compared to chemotherapy alone. This benefit seems to be limited to patients with complete cytoreduction. The reason for limited outcome in patients with suboptimal surgery could be residual disease, peri-operative characteristics or tumor biology. While TFST is an often-used parameter in oncologic trials, its role in surgical trials is not defined.


Analysis of characteristics of surgery and systemic treatment, surgical complications, and tumor biology as predictive and prognostic factors. For this analysis, patients were splitted into 3 subgroups: (1) Control arm vs (2) surgical arm but no complete resection vs (3) surgical arm and complete resection.


Group 1 included 201 patients, group 2 included 65 of (46 with documented tumor residuals after surgery, 16 without surgery, 3 without data about residuals) and group 3 included 141 patients. The use of platinum-based chemotherapy was 90% in group 1 vs 83.1% in group 2 and 91.5% in group 3. The use of bevacizumab was about 23% and PARP-inhibitors in < 10% in all groups. Median duration of surgery was 204 minutes in group 2 and 230 minutes in group 3. Time from randomization to start of systemic therapy was 15 days in group 1 vs 51 and 53 days in group 2 and 3, respectively. The re-laparotomy rate was about 3% in group 2 and 3. 30-day mortality rate was 0 in all arms. TFST in the surgical arm was significantly longer compared to the non-surgical arm (16.0 vs 21.3 months; p<0.001). TFST in group 1 vs 2 vs 3 was 16.0 vs 16.1 vs 26.3 months, respectively (p<0.001).


Suboptimal surgery seems to have similar burden as complete resection. Therefore, preoperative selection in an experienced Gynecologic Oncology center is indicated to avoid suboptimal debulking. TFST is prolonged substantially by complete resection.

Clinical trial identification


Editorial acknowledgement

Legal entity responsible for the study

AGO Study Group.




F. Lecuru: Advisory/Consultancy, Travel/Accommodation/Expenses: AstraZeneca; Advisory/Consultancy, Travel/Accommodation/Expenses: Tesaro; Advisory/Consultancy: Clovis Oncology. A. du Bois: Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Roche/Genentech; Advisory/Consultancy: Genmab; Advisory/Consultancy: Clovis Oncology; Advisory/Consultancy: Tesaro; Advisory/Consultancy: BioCad; Advisory/Consultancy: Ingress Health; Advisory/Consultancy: TLC Biopharmaceuticals. J. Sehouli: Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Clovis Oncology; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: PharmaMar; Advisory/Consultancy, Research grant/Funding (institution): Merck; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution): Pfizer; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Tesaro; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: MSD Oncology; Advisory/Consultancy: Lilly; Advisory/Consultancy: Novocure; Travel/Accommodation/Expenses: Olympus; Honoraria (self), Advisory/Consultancy: Johnson & Johnson; Travel/Accommodation/Expenses: Roche Pharma AG; Honoraria (self): Eisai; Honoraria (self): Olympus Medical Systems; Honoraria (self): Teva; Honoraria (self): GlaxoSmithKline; Honoraria (self), Research grant/Funding (institution): Bayer; Research grant/Funding (institution): Roche. I.B. Vergote: Advisory/Consultancy: PharmaMar; Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche; Advisory/Consultancy: Merck Sharp & Dohme; Advisory/Consultancy, Research grant/Funding (institution): Genmab; Advisory/Consultancy: Millennium; Advisory/Consultancy: Clovis Oncology; Advisory/Consultancy: Immunogen; Advisory/Consultancy, Travel/Accommodation/Expenses: Tesaro; Advisory/Consultancy, Research grant/Funding (institution): Oncoinvent; Advisory/Consultancy: Sotio; Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Amgen; Advisory/Consultancy, Travel/Accommodation/Expenses: AstraZeneca; Advisory/Consultancy: Carrick Therapeutics; Advisory/Consultancy: Debiopharm Group; Advisory/Consultancy: GlaxoSmithKline; Advisory/Consultancy: Medical University of Vienna; Advisory/Consultancy: Octimet; Travel/Accommodation/Expenses: MSD/Merck. G. Ferron: Advisory/Consultancy: Olympus; Advisory/Consultancy, Travel/Accommodation/Expenses: AstraZeneca; Advisory/Consultancy: GlaxoSmithKline/Tesaro; Travel/Accommodation/Expenses: Roche Pharma AG; Travel/Accommodation/Expenses: PharmaMar. W. Meier: Honoraria (self): AstraZeneca; Honoraria (self): Tesaro; Honoraria (self): Roche. S. Greggi: Advisory/Consultancy: AstraZeneca; Advisory/Consultancy, Travel/Accommodation/Expenses: Roche. F. Selle: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Roche; Honoraria (self), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Tesaro; Honoraria (self), Speaker Bureau/Expert testimony: GlaxoSmithKline; Honoraria (self), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: PharmaMar; Honoraria (self), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: MSD; Honoraria (self): Clovis Oncology. C. Pomel: Honoraria (self), Advisory/Consultancy: AstraZeneca; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Roche; Honoraria (self): GlaxoSmithKline; Honoraria (self), Advisory/Consultancy: Clovis Oncology. E.H. Avall-Lundqvist: Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Tesaro; Advisory/Consultancy: Clovis Oncology; Advisory/Consultancy: Genmab; Honoraria (self): Roche. J. Ponce: Advisory/Consultancy: Medtronic; Advisory/Consultancy: Abex; Advisory/Consultancy: KCI. F. Raspagliesi: Advisory/Consultancy: Tesaro-GSK; Travel/Accommodation/Expenses: Roche. G-M. Sadaf: Travel/Accommodation/Expenses: AstraZeneca; Travel/Accommodation/Expenses: Johnson & Johnson. A. Reinthaller: Honoraria (self), Travel/Accommodation/Expenses: Roche; Honoraria (self), Travel/Accommodation/Expenses: PharmaMar; Honoraria (self), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Travel/Accommodation/Expenses: Tesaro; Honoraria (self): Novartis; Honoraria (self): GlaxoSmithKline; Honoraria (self): Amgen. P. Harter: Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution): AstraZeneca; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution): Roche; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution): Tesaro; Advisory/Consultancy: Merck; Honoraria (self): Clovis Oncology; Honoraria (self): Stryker; Honoraria (self): MSD Oncology; Honoraria (self): Zai Lab; Honoraria (self): Lilly; Honoraria (self): Sotio; Research grant/Funding (institution): Genmab. All other authors have declared no conflicts of interest.

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