2022-RA-1157-ESGO Is still possible to treat ovarian cancer in a district general hospital? Considerations from our experience. (20th October 2022) - Comerci, Giuseppe
Abstract : Introduction/Background: Epithelial ovarian cancer continues to be the leading cause of death from gynaecological malignancies. Most patients present at advanced stage, which contributes to the high mortality rates. We all know that patients treated by gynaecologic oncologists at cancer centers have better survival outcomes. The purpose of this study is to show our experience in a district general hospital. Methodology: Retrospective audit study Results: Between January 2011 and June 2020 we treated 170 patients with ovarian cancer; 127pts (74%) showed an advanced stage. Mean age was 61.7 years. Patients were treated by TAH and BSO or USO with multivisceral resections. Neoadjuvant chemotherapy (NACT) was performed in 46 pts (26, 9%); interval surgery (IS) in 43 cases and primary surgery (PS) in 124 patients (73, 1%). Residual disease was 0 (68%), < 1 cm (16%), > 1 cm (16%). All the operation were done by single surgeon (GC) with the help of abdominal surgeon (AV) when needed. Total overall survival (OS) was 39.7 months. OS for patients undergone to PS was 41.7 months, and 32.8 months in the group of IS. Recurrence disease was observed in 29.7% of patients. Conclusion: We wanted to review all our ovarian cancer cases in order to see if our clinical outcome were similar at other gynaecological cancer unit. We have clear in mind that the most important prognostic factor associated with improved survival is a complete resection of the all visible disease. We strong believe that if there are all the facilities inside the hospital to upfront this illness and there are the oncological culture together with the surgical skills is still possible to treat ovarian cancer patients in a district general hospital with comparable clinical outcome.