Title |
Multidisciplinary Surgical Approach to Increase Survival for Advanced Ovarian Cancer in a Tertiary Gynaecological Oncology Centre
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Published in |
Annals of Surgical Oncology, October 2023
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DOI | 10.1245/s10434-023-14423-1 |
Pubmed ID | |
Authors |
Karen Mulligan, Edward Corry, Fionán Donohoe, Kate Glennon, Carolien Vermeulen, Gillian Reid-Schachter, Claire Thompson, Tom Walsh, Conor Shields, Orla McCormack, John Conneely, Mohammad Faraz Khan, William D. Boyd, Ruaidhrí McVey, Donal O’Brien, Ann Treacy, Jurgen Mulsow, Donal J. Brennan |
Abstract |
The purpose of this paper is to report on changes in overall survival, progression-free survival, and complete cytoreduction rates in the 5-year period after the implementation of a multidisciplinary surgical team (MDT). Two cohorts were used. Cohort A was a retrospectively collated cohort from 2006 to 2015. Cohort B was a prospectively collated cohort of patients from January 2017 to September 2021. This study included 146 patients in cohort A (2006-2015) and 174 patients in cohort B (2017-2021) with FIGO stage III/IV ovarian cancer. Median follow-up in cohort A was 60 months and 48 months in cohort B. The rate of primary cytoreductive surgery increased from 38% (55/146) in cohort A to 46.5% (81/174) in cohort B. Complete macroscopic resection increased from 58.9% (86/146) in cohort A to 78.7% (137/174) in cohort B (p < 0.001). At 3 years, 75% (109/144) patients had disease progression in cohort A compared with 48.8% (85/174) in cohort B (log-rank, p < 0.001). Also at 3 years, 64.5% (93/144) of patients had died in cohort A compared with 24% (42/174) of cohort B (log-rank, p < 0.001). Cox multivariate analysis demonstrated that MDT input, residual disease, and age were independent predictors of overall (hazard ratio [HR] 0.29, 95% confidence interval [CI] 0.203-0.437, p < 0.001) and progression-free survival (HR 0.31, 95% CI 0.21-0.43, p < 0.001). Major morbidity remained stable throughout both study periods (2006-2021). Our data demonstrate that the implementation of multidisciplinary-team, intraoperative approach allowed for a change in surgical philosophy and has resulted in a significant improvement in overall survival, progression-free survival, and complete resection rates. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Ireland | 22 | 35% |
United States | 4 | 6% |
India | 3 | 5% |
United Kingdom | 2 | 3% |
Spain | 1 | 2% |
France | 1 | 2% |
Canada | 1 | 2% |
Germany | 1 | 2% |
Colombia | 1 | 2% |
Other | 2 | 3% |
Unknown | 24 | 39% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 38 | 61% |
Scientists | 13 | 21% |
Practitioners (doctors, other healthcare professionals) | 9 | 15% |
Science communicators (journalists, bloggers, editors) | 2 | 3% |