753 The role of douglasectomy instead of random biopsies in the surgical treatment of presumed FIGO stage I ovarian cancer

Introduction/Background Douglasectomy is defined as the removal of the pelvic peritoneum of the entire pouch of Douglas and not random blind biopsies from the normal appearing pelvis. The rationale behind this is that isolated microscopic cancer cells might disseminate from the ovaries to their neighboring pelvic peritoneum. However, in presumed FIGO Stage I ovarian cancer a simple hysterectomy with bilateral salpingo-oophorectomy is the standard of care in the pelvis. This study aims to investigate the impact of douglasectomy on the survival of patients with early ovarian cancer. Methodology We retrospectively analyzed the records of patients with presumed FIGO Stage I ovarian cancer that underwent surgery in the 1st Department of Obstetrics – Gynecology Clinic from 2012 – 2022. Patient characteristics, oncological and follow-up information were collected. The primary outcome were the survival rates between patients with simple hysterectomy and en block hysterectomy-douglasectomy. Results 88 patients met the inclusion criteria to be included in the final analysis. Patients were categorized into two groups: Group A (27 patients) with douglasectomy and Group B (61 patients) with no douglasectomy. There was no statistically significant difference in age, BMI, comorbidities, intraoperative blood loss and ICU admittance between the two groups. On the other hand, patients with en-block hysterectomy-douglasectomy had a statistically significant higher pre-operative CA-125 values, surgery duration, rate of postoperative complications and hospital stay. Concerning survival rates, there was a statistically significant difference in disease-free survival (p=0.033), but no difference was observed in overall survival (p=0.66). Conclusion En-block removal of the pelvic peritoneum of the entire pouch of Douglas with the uterus is a safe and feasible technique during surgery for early ovarian cancer, which leads to improved disease-free survival. Further prospective randomized trials are needed to validate these promising practice changing results. Disclosures No disclosures.