484 Should patients with advanced stage ovarian cancer and preoperative hyponatremia be excluded from primary debulking surgery?

Introduction/Background Ovarian cancer remains an aggressive malignancy with poor rates in terms of survival even in cases in which debulking surgery to no residual disease is achieved. Therefore, attention was focused on identifying other prognostic markers which might be associated with poorer outcomes in order to provide a better selection of cases submitted to per primam surgery Methodology Data of patients submitted to primary debulking surgery between 2014 -2020 in Ion Cantacuzino hospital were retrospectively reviewed. Finally a total number of 107 patients was identified. Preoperative data regarding laboratory tests, intraoperative data regarding the completeness of cytoreduction and postoperative data regarding the long term outcomes were reviewed. A serum value of 136 for natrium was considered as cut off, patients being further classified in cases with hyponatremia – 41 cases and cases with normal natrium levels – 66 cases. Results Patients diagnosed with preoperative hyponatremia proved to be diagnosed more often in advanced stages of the disease (IIIC,IV) when compared to those with normal natrium values (p=0,0012). Moreover, among patients diagnosed in advanced stages (FIGO IIIC and IV) hyponatremia was more often encountered in cases in which debulking surgery was not achieved (p=0,003). Meanwhile, hyponatremia was also found to be statistically significant associated with a higher volume of ascites (p=0,002), with lower levels of serum albumin (p=0,004) and with higher rates of postoperative complications (p=0,004). As for the long term outcomes, patients diagnosed with preoperative hyponatremia and advanced stages of the disease reported a significantly poorer overall survival when compared to those with normal sodium levels. However, this difference was not statistically significant when comparing the overall survivals between hyponatremic and normonatremic patients along all stages of the disease. Conclusion Preoperative hyponatremia might become an useful tool in order to identify caseswith poorer outcomes especially among advanced stages of the disease. Disclosures None.