the calculated predictive probability values were significantly different between the LNM-positive and -negative groups (P = 1.39 × 10 -10 ), and high diagnostic accuracy of 83.6% area under the curve (AUC) was obtained. The LNM diagnosis requires essentially minimize the time difference between the diagnosis and hysterectomy. Therefore, reverse transcriptionpolymerase chain reaction enabled quantification from RNA in one step within 30 min, for intraoperative diagnosis. Conclusion This diagnostic method uses rapid nucleic acid amplification for intraoperative quantification of biomarkers in the primary tissue. Furthermore, the predictive model combined with various clinical variables can be used to discriminate LNM with high accuracy and facilitate individualization of the surgical treatment.

Aim: Surgery for advanced ovarian cancer (AOC) has evolved over the past decade to ingeminate the need to offer maximum effort surgery (MES). The aim of this study is to analyze the implementation of a paradigm shift in the surgical management of women with AOC at the University Hospitals of Leicester NHS Trust (UHL) in 2015, until 2020, compared to 2011-2014. Methods: Retrospective cohort study of women with AOC who underwent cytoreductive surgery (CRS) in the UHL. The two groups were: 153 women from January 2011 to December 2014 (group 1), 136 women from January 2015 to January 2020 (group 2). Results: In group 1, the 1, 3, and 5 years overall survival rates (OS) were, 90.4%, 33.7%, and 19.3%, compared to 90.2%, 55.4%, and 29.7%, respectively, in group 2 (p = 0.012). Significantly more women had CRS in group 2: 45-Primary debulking surgery (PDS) and 57-interval debulking surgery (IDS) versus 17-PDS & 67-IDS in group 1 (p < 0.001). Surgical complexity score (modified Aletti score) was higher in group 2 compared to group 1 (p = <0.001). No significant difference was noted in the postoperative complications, in group 2, in women who underwent PDS versus IDS, yet PDS was associated with higher OS. Conclusions: MES/CRS in women with AOC significantly improves OS. Our data highlights the importance of a dedicated team to implement this change in cancer centers. Where possible, suitable women with AOC likely to have complete cytoreduction based on preoperative assessment, should be offered PDS.

Background/Aim: Some studies have shown that ovarian cancer patients admitted after referral to the emergency department had a worse prognosis than those referred through non-emergency pathways. We believe that our study is the first in the UK to explore this difference and aimed to compare the 1-year, 3-year, and 5-year overall survival rates of ovarian cancer patients referred non-urgently from the general practitioner (GP) vs. patients referred urgently to the emergency department (ED). Patients and Methods: This was a retrospective cohort study conducted at the University Hospitals of Leicester (UHL) from 1 st January 2015 to 31 st December 2019 involving 298 ovarian cancer patients: 197 referred nonurgently from the GP and 101 patients referred to the ED. Results: There was no significant difference in the 1-year, 3-year, and 5-year overall survival in ovarian cancer patients referred from the GP compared to patients referred to the ED, 84.8%, 62.2%, and 48.4% versus 80.2%, 64.8%, and 43.5%, respectively (p=0.732). Conclusion: The mode of referral for ovarian cancer patients may not affect their prognosis. Prompt referral to the gynaecological oncology multidisciplinary team, a good acute oncology service, early imaging and image-guided diagnostic pathways, timely appointment, and timely initiation of treatment in our centre may have minimized the difference in outcome in the two groups. Patients and MethodsWe conducted a retrospective cohort study of ovarian cancer patients presenting to the University Hospitals of Leicester (UHL)