VP100 Ultraradical Ovarian Cancer Surgery Comparative Clinical Effectiveness

2019 ◽  
Vol 35 (S1) ◽  
pp. 97-97
Author(s):  
Carole Cummins ◽  
Hannah Patrick ◽  
Joanna Long ◽  
Satyam Kumar ◽  
Sudha Sundar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Residual Disease ◽  
Advanced Ovarian Cancer ◽  
Cancer Surgery ◽  
Routine Practice ◽  
Complication Rates ◽  
Patient Reported ◽  
Surgical Complexity

IntroductionOvarian Cancer is usually diagnosed at an advanced stage. Extensive or ultra-radical surgery aims to improve the outcome by removing all visible tumour. National Institute for Health and Care Excellence UK 2013 Guidance expressed concern about its efficacy and safety, recommending research comparing complication rates, survival and quality of life with those following standard surgery. We present prospective observational data on quality of life and survival following surgery for advanced ovarian cancer. Innovative methods were used to collect patient reported outcomes and complex surgical information to compare outcomes of surgery of greater or lesser complexity used in routine practice.MethodsA cohort study collected disease, surgical, complications, survival and quality of life data (validated instruments including EURO-QOL, EORTC-30 and OVA28) across a 2-year period in 12 United Kingdom sites and in parallel studies in Melbourne, Australia and Kolkata, India.ResultsTwo hundred and sixty patients undergoing cytoreductive surgery were recruited in 12 months. Centres varied in utilisation of complex surgical procedures. Excluding patients with inoperable disease, 125 patients underwent low, 70 intermediate and 63 high Surgical Complexity Score (SCS) procedures. Complete cytoreduction with < 1cm residual disease was achieved in 100/125 (80 percent) low, 65/70 (92 percent) intermediate, and 57/63 (90 percent) high SCS groups (p = 0.023). Compliance with 12 months questionnaires was 89%. All surgical groups had improved EORTC QLC 30 Global at 12 months compared with prior to operation, with overlapping 95% confidence intervals and no between group differences at 12 months. Complications, survival and quality of life adjusted for disease burden and surgical complexity over 2 years’ follow-up will be described.ConclusionsResults will inform the update of NICE Interventional Procedures guidance recommendations on clinical governance arrangements for ovarian cancer surgery and enable clinicians and patients to better understand the outcomes of surgery, informing the consent process.

Patient-Reported Outcomes After Extensive (Ultraradical) Surgery for Ovarian Cancer: Results From a Prospective Longitudinal Feasibility Study

2015 ◽  
Vol 25 (9) ◽  
pp. 1599-1607 ◽  
Author(s):  
San Soo Hoo ◽  
Natalie Marriott ◽  
Aimee Houlton ◽  
James Nevin ◽  
Janos Balega ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Patient Reported Outcomes ◽  
Complexity Score ◽  
Patient Reported ◽  
Surgical Complexity ◽  
Prospective Longitudinal ◽  
The Impact ◽  
Extensive Surgery

BackgroundExtensive (ultraradical) surgery may facilitate complete cytoreduction in ovarian cancer with potential survival benefit but with greater morbidity. Currently, patient-reported outcomes (PROs) from such surgery are unknown. We conducted the Surgery in Ovarian Cancer Quality of life Evaluation Research study (SOCQER 1), a prospective study investigating the feasibility of collection of serial PROs in patients who had extensive surgery and standard surgery for ovarian cancer.MethodsNinety-three patients were recruited for 33 months to complete serial PRO assessments using the validated EORTC QLQ-C30 and the ovarian cancer–specific QLQ-OV28 questionnaires preoperatively, at 6 weeks, and at 3, 6, and 9 months postoperatively. Aletti Surgical Complexity Score of 3 or lower was considered standard surgery; a Surgical Complexity Score of 4 or higher was considered extensive surgery. Prospective data collection was obtained from the hospital electronic database, including patient demographics, American Society of Anaesthesiologists grade, preoperative serum CA125 and albumin levels, chemotherapy regimen, and surgical morbidity.ResultsThree cohorts of patients—32 benign, 32 undergoing standard surgery, and 24 undergoing extensive surgery—completed the questionnaires. Median questionnaire completion rate in this study was 64%, demonstrating the feasibility of longitudinal quality of life (QoL) assessment after surgery. Patient-reported outcomes revealed a falling trend in QoL in the short-term (6 weeks-3 months) after surgery, which gradually returned to baseline at 6 to 9 months; this trend was more marked after extensive surgery.ConclusionsThis study provides useful insight into the impact of extensive surgery on patients. Further multicenter studies are needed to evaluate the impact of extensive surgery on patient’s QoL and survival.

scholarly journals Recommended Patient-Reported Core Set of Symptoms and Quality-of-Life Domains to Measure in Ovarian Cancer Treatment Trials

2014 ◽  
Vol 106 (7) ◽  
Author(s):  
Kristine A. Donovan ◽  
Heidi S. Donovan ◽  
David Cella ◽  
Martha E. Gaines ◽  
Richard T. Penson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Cancer Treatment ◽  
Life Domains ◽  
Treatment Trials ◽  
Core Set ◽  
Patient Reported

MP84-12 PATIENT-REPORTED QUALITY OF LIFE AND CONVALESCENCE AFTER MINIMALLY INVASIVE KIDNEY CANCER SURGERY

2015 ◽  
Vol 193 (4S) ◽  
Author(s):  
Peter Chang ◽  
Jialin Mao ◽  
Kimberly Taylor ◽  
Ostap Dovirak ◽  
Arie Carneiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Minimally Invasive ◽  
Kidney Cancer ◽  
Cancer Surgery ◽  
Patient Reported

scholarly journals Patient-reported outcomes in ovarian cancer

2017 ◽  
Vol 5 (2) ◽  
pp. 51-54
Author(s):  
Ilaria Sabatucci ◽  
Francesco Perrone
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Patient Reported Outcomes ◽  
Cancer Treatments ◽  
Treatment Benefit ◽  
Functional Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

Ovarian cancer treatments may negatively impact the physical and functional quality of life domains of patients. Patient-reported outcomes (PROs) and health-related quality of life (HR-QoL) assess the health conditions of patients without interpretation by a clinician of the patient’s response. A broad spectrum of validated questionnaires investigating HR-QoL exist. However, none are considered as a gold standard of PRO measures. In clinical trials, PROs are a means of evaluating treatment benefit or risk in a way that complements the typical primary outcome of survival, and are necessary endpoints to support regulatory approval. In clinical practice, PROs are useful in monitoring the ability of patients to tolerate treatment and in identifying patients more at risk for subsequent health problems who would benefit from supportive care during and after treatment.

Does Palliative Chemotherapy Palliate? Evaluation of Expectations, Outcomes, and Costs in Women Receiving Chemotherapy for Advanced Ovarian Cancer

2001 ◽  
Vol 19 (5) ◽  
pp. 1266-1274 ◽  
Author(s):  
Catherine Doyle ◽  
Michael Crump ◽  
Melania Pintilie ◽  
Amit M. Oza
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Palliative Chemotherapy ◽  
Advanced Ovarian Cancer ◽  
Patient Expectations ◽  
Global Function ◽  
Emotional Function ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

PURPOSE: The value of palliative chemotherapy in women with refractory and recurrent ovarian cancer is difficult to quantify, and little is known about patient expectations from these treatments. We evaluated in the current prospective study patient expectations, palliative outcomes of chemotherapy, and the inherent resource utilization in patients undergoing second- or third-line chemotherapy for recurrent or refractory advanced ovarian cancer. METHODS: The European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (EORTC QLQ C30) and Functional Assessment of Cancer Therapy-Ovarian (FACT-O) questionnaires were used to assess palliative benefit and an in-house questionnaire was used to gauge patient expectations. The minimal clinically important difference (MCID) was calculated by asking women to make a global rating of change and correlating this to the EORTC QLQ C30. Resource use was recorded and costs were calculated. RESULTS: Twenty-seven patients were accrued. Objective response was documented on seven of 27. The median survival was 11 months. Sixty-five percent of women expected that chemotherapy would make them live longer and 42% that it would cure them. After two cycles, quality-of-life (QL) improvement was seen particularly in global function (11 of 21) and emotional function (13 of 21) with EORTC QLQ C-30. Improvement was sustained for a median of 2 and 3 months, respectively, in these categories. The MCID was calculated to be 0.39 on a seven-point scale for physical function and 0.13 for global function. The mean total cost per patient for the study period was Can $12,500. CONCLUSION: Patient expectations from these treatments are often unrealistic. Although objective responses are low, active palliation with chemotherapy is associated with substantive improvement in patients’ emotional function and global QL, with overall costs that seem relatively modest.

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